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![[Cardiac Imaging Clinic Iidabashi -CVIC-] Specialist team for cardiac MRI examinations, heart checkups, and image diagnosis | Shinjuku-ku, Tokyo](https://static.wixstatic.com/media/954c1b_c9f92d9318d64748b3e153bd27aac699~mv2.png/v1/fill/w_560,h_70,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/cvic_logo_600.png){kind=logo}
When referral from a medical institution
(You can download the medical information provision form)
1. Please call 03-5206-5956 to reserve the inspection date and time.
2. After the appointment date and time has been decided, please fill in the items and fax to the our hospital. (FAX: 03-5206-5958).
3. Please the second "reservation slip" give to the examinee.
If you do not have the letter of introduction,
please download and use it.
If you cannot download or your department does not have an internet connection, we will send you a letter of introduction. Please feel free to contact us.
患者様がご来院後に問診票をご記入いただいています。
問診票がダウンロードできますので、時間節約のためあらかじめご記入のうえ、ご持参いただく事をおすすめします。
![[Cardiac Imaging Clinic Iidabashi -CVIC-] Specialist team for cardiac MRI examinations, heart check-ups, and image diagnosis | Shinjuku-ku, Tokyo](https://static.wixstatic.com/media/954c1b_4e5b7cb425704895b3e0da51274b7974~mv2.png/v1/fill/w_80,h_80,al_c,q_85,enc_avif,quality_auto/cvic_2.png)
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