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Doitsu Meister Gankyouin
Reservation / Contact
For your second and third choice of date and time, please select a different day or time from your first choice. It may be difficult to make a reservation if the time slots are consecutive. In addition, please note that we are unable to accept requests for a particular staff member.
Name
required
Surname
First name
Gender
required
Male
Female
Date of Birth
required
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/
years old
Use of our store
required
First time
Repeat
Referral
E-mail address
required
Confirmation
Phone number
required
-
-
Address
required
Postal Code
Prefecture
City
Address
Apartment / Building
Use of eyeglasses
required
Yes
No
Years of use
Use of contact lenses
required
No
Soft
Hard
Years of use
Inquiry
required
I Want to get new glasses
Birthday Glasses Check-Up
Eye Strain
Fitting adjustment only (repeater)
Difficulty seeing things
Optometry appointment (repeater)
Difficulty seeing things near by / PC
Purchase New glasses and lenses (repeater)
Lack of three-dimensionality / Double vision
Repair (repeater)
Deep vision/dynamic vision
Semi-annual inspection for children (repeater)
Glasses do not fit
Children's fit adjustment only (repeater)
Others (fill in the remarks column)
First Choice
required
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sep.
Oct.
Nov.
Dec.
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11:30
12:00
12:30
13:00
13:30
14:00
14:30
15:00
15:30
16:00
16:30
17:00
17:30
18:00
Second Choice
required
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
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Oct.
Nov.
Dec.
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11:30
12:00
12:30
13:00
13:30
14:00
14:30
15:00
15:30
16:00
16:30
17:00
17:30
18:00
Third Choice
required
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sep.
Oct.
Nov.
Dec.
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11:30
12:00
12:30
13:00
13:30
14:00
14:30
15:00
15:30
16:00
16:30
17:00
17:30
18:00
Questions
required
I will check my inbox and spam folder.
Please fill in if you have any other inquiries
You may not receive emails from our store depending on the device or types of email address you are using. If you do not receive a reply from us after 3 days, please check your spam folder and call us at the number below.
03-6804-1699
Please note that general reservations, consultations, and inquiries are "accepted by email only".
confirm