Documents Required for Your Hospital Stay

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Preparing for Your Hospital Stay (Booklet)

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・Please fill in the “Declaration Form”, “Verification of Hospital Admission History ”, and “Application for Patient Wear Rental and Diaper Service” in advance, and bring it with you at the time of your admission.

・The joint guarantor of the Declaration Form is limited to those who can bear the medical expenses etc. in a responsible manner, and who belongs to a different household from the guarantor of the patient’s identity (relatives, acquaintances, friends, siblings in different households, parents, children, etc.).

Required Information

  • Hospital card
  • Insurance card and other medical certificates
　(Certificate of Limitation Application [if applicable], Welfare Medical, Public Medical, etc.)
  • Declaration Form (Front Side) and ADMISSION HISTORY(Back Side)
　※Please fill out in advance.
  • Application for Rental Hospital Gown,Diaper Set, and Medical Se
　※Please submit the application form  to Desk 35 at the Hospital Gown Rental Office, located on the 1st floor of the Outpatient Building.

  • Application for Rental Hospital Gown

  • Medical Set

Requests

  •  Please bring  "Admission Information Handbook" with you during your stay.
  • In cases where the insurance card is not presented, the full amount may be self-billed.
  • If there are any changes, renewals, or modifications to the information on the insurance card or medical recipient card, please promptly present it at the admission counter. If the presentation is delayed,insurance coverage may not apply, and the full amount may be self-billed.
  • If hospitalization is due to a traffic accident or work-related injury,please inform the admission counter, as different insurance may apply.