MEDI Online Booking and Inquiry Form

Please fill out the form below in English or Japanese.

We endeavor to respond to all messages within 5 working days.
If you do not hear from us within this time, please kindly contact us again. (Please also check your spam filter setting and allow "@medi-counseling.com" )
Our regular opening time is Tue to Sat, from 10am to 7pm (except public holidays).

Due to recent high demand for appointments, we may need to ask you to wait for some time before setting the initial session.

mandatory fields
Name
Sex
Booking or inquiry
E-mail address

confirm your e-mail address
Phone number
 -  - 
Address (e.g. Nishitemma, Kita-ku, Osaka-shi)
Location confirmation

* We now see clients at Osaka room only.

* From December 2015, the room is at a new location (about 5 min walk from the previous premises). Please check our website for our new address and phone number.
Preferred dates for your initial session (please provide several if possible)
Days available for on-going sessions

* Sundays and Mondays are currently closed for counseling in English.
Times usually available for counseling

Please try to include 10am-7pm, our regular opening hours (we may struggle arranging 7-9pm slots on a regular basis)
Therapies of your interest at this moment

* You could also discuss this with us and make your choice at your initial appointment.
Main issue(s) that you would like to discuss in counseling, and/or your queries
Language(s) that you speak