Step 1

Which specialist do you need?

Match your symptoms to the right type of doctor before searching the Clinic Finder.

General / Internal Medicine

  • Fever, cold, or flu symptoms
  • Fatigue or general unwellness
  • High blood pressure or diabetes management
  • Annual check-ups and immunizations
  • Not sure which specialist to see
General Clinic

Pediatrics

  • Child fever, cold, or infection
  • Rashes or skin concerns in children
  • Child vaccinations and growth checks
  • Behavioral or developmental concerns
Pediatric Clinic

Cardiology

  • Chest pain or tightness
  • Irregular heartbeat or palpitations
  • Shortness of breath at rest
  • High blood pressure follow-up
Cardiologist

Orthopedics

  • Joint pain, back pain, or stiffness
  • Sports injuries or muscle strains
  • Broken or fractured bones
  • Knee, shoulder, or hip pain
Orthopedic Clinic

Dermatology

  • Rashes, hives, or eczema
  • Acne, moles, or skin growths
  • Hair loss or scalp conditions
  • Allergic skin reactions
Dermatologist

Gastroenterology (GI)

  • Stomach pain, bloating, or nausea
  • Diarrhea or constipation lasting over a week
  • Acid reflux or heartburn
  • Blood in stool or unexplained weight loss
GI Clinic

ENT (Ear, Nose & Throat)

  • Persistent sore throat or tonsil issues
  • Ear pain, hearing loss, or ringing
  • Chronic sinus congestion or nosebleeds
  • Hoarseness or voice changes
ENT Clinic

Gynecology

  • Menstrual irregularities or pain
  • Pregnancy care and check-ups
  • Pelvic pain or unusual discharge
  • Mammograms and breast health
Gynecologist

Urology

  • Painful or frequent urination
  • Blood in urine
  • Kidney stone symptoms
  • Male reproductive health concerns
Urologist

Mental Health / Psychiatry

  • Persistent low mood, depression, or hopelessness
  • Anxiety, panic attacks, or constant worry
  • Sleep difficulties not caused by physical illness
  • Difficulty functioning at work or in daily life
  • Emotional distress you cannot manage on your own
Mental Health Clinic

Physiotherapy & Chiropractic

  • Back, neck, or joint pain after injury or strain
  • Recovering from surgery or sports injury
  • Posture-related pain or repetitive strain
  • Stiffness or reduced range of motion
  • Muscle imbalances or rehabilitation needs
Physiotherapy & Chiropractic

Ophthalmology

  • Blurry or deteriorating vision
  • Eye pain, redness, or persistent irritation
  • Eye discharge or foreign object in the eye
  • Floaters, flashes of light, or sudden vision loss
  • Routine eye check-ups or prescription updates
Ophthalmology Clinic

Oncology

  • Diagnosed or suspected cancer requiring specialist care
  • Unexplained weight loss, fatigue, or night sweats
  • Persistent lumps or growths that do not resolve
  • Follow-up or ongoing cancer treatment
Oncology Clinic

Podiatry

  • Foot or heel pain, including plantar fasciitis
  • Ingrown toenails or nail infections
  • Bunions, corns, or calluses
  • Diabetic foot care or circulation concerns in feet
  • Ankle instability or gait problems
Podiatry Clinic


Step 3

Medical questionnaire forms

These bilingual forms are used by clinics and hospitals across Japan. Print the one that matches your appointment, fill it in before you go, and hand it to the receptionist — it removes the language barrier before you even see the doctor.

Each form below opens the official PDF. Print it, fill it in at home, and bring it to your appointment. All forms are bilingual — English on the left, Japanese on the right. The Japanese version takes priority in case of any translation discrepancy.

General & Internal Medicine

Internal Medicine / General Practice
内科 問診票 — for colds, fever, fatigue, general concerns

Use this form when visiting a general clinic for symptoms like fever, cough, fatigue, nausea, weight loss, or any concern that doesn't fit a specific specialty. Covers current symptoms, medication history, and past conditions.

Current symptoms Symptom onset & severity Medication list Past conditions Surgery history Allergies Smoking & alcohol
Open PDF form

Print and fill in before your appointment. Bring it alongside your insurance card.

Respiratory Medicine
呼吸器内科 問診票 — for cough, asthma, breathing issues

Use this form for respiratory concerns including cough, wheezing, shortness of breath, chest pain, or phlegm. Includes phlegm characteristics and symptom patterns.

Cough, wheeze, breathing Phlegm details Symptom timing Medication list Allergies Smoking history
Open PDF form

Specialist Forms

Cardiology
循環器科 問診票 — for chest pain, palpitations, heart concerns

For chest pain, palpitations, shortness of breath, irregular pulse, dizziness, or swelling. Includes a body diagram to mark where pain occurs and detailed pain type options.

Chest pain type & location Palpitations & pulse Symptom triggers Medication list Past cardiac history
Open PDF form
Gastroenterology
消化器科 問診票 — for stomach, bowel, and digestive issues

For nausea, vomiting, diarrhea, constipation, heartburn, bloody stool, appetite loss, or weight loss. Includes detailed stool characteristics and body diagram.

Nausea, vomiting, diarrhea Stool characteristics Appetite & weight Symptom body diagram Medication list
Open PDF form
Dermatology
皮膚科 問診票 — for rashes, itching, skin conditions

For rashes, hives, eczema, itching, dry skin, moles, burns, insect bites, athlete's foot, or any skin concern. Includes a body diagram to mark affected areas.

Skin symptom type Affected area diagram Severity scale Medication & allergy history
Open PDF form
Pediatrics
小児科 問診票 — for children's health visits

For children's clinic visits. Covers fever, rash, vomiting, ear pain, and developmental concerns. Includes vaccination history, feeding method, birth conditions, and current spreading illnesses at school or nursery.

Symptoms & fever School illness outbreaks Vaccination record Feeding & birth history Development concerns
Open PDF form
Psychiatry / Mental Health
精神科 問診票 — for anxiety, depression, mental health concerns

For anxiety, depression, insomnia, low energy, concentration difficulties, or other mental health concerns. Includes current symptom trend and work, school, or family stressors.

Mood & energy symptoms Anxiety & sleep Symptom improving or worsening Stress source Medication list
Open PDF form
Surgery / General Surgery
外科 問診票 — for injuries, lumps, swelling, surgical concerns

For injuries, lumps, swelling, hemorrhoids, or any concern requiring surgical evaluation. Includes stool details and a full body symptom diagram.

Injury & swelling Pain & lumps Stool characteristics Surgery history Body diagram
Open PDF form
Vascular Surgery
血管外科 問診票 — for varicose veins, cold limbs, circulation

For varicose veins, cold hands and feet, leg cramps when walking (intermittent claudication), or other circulation concerns.

Varicose veins Cold limbs Walking pain Body diagram Medication list
Open PDF form
Urology
泌尿器科 問診票 — for urinary issues, blood in urine

For frequent urination, difficulty urinating, blood in urine, pain when urinating, or urinary incontinence. Also covers sexual health concerns.

Urinary symptoms Blood in urine Pain & frequency Medication list Past conditions
Open PDF form
Neurosurgery
脳神経外科 問診票 — for headaches, dizziness, numbness, stroke concerns

For headaches, dizziness, numbness, paralysis, vision disturbance, difficulty speaking, or stroke-related concerns. Distinguishes between ongoing symptoms and temporary episodes.

Headache & dizziness Numbness & paralysis Vision & speech issues Temporary vs ongoing Medication list
Open PDF form
Orthopedics
整形外科 問診票 — for joint pain, injuries, numbness, stiffness

For joint pain, sprains, injuries, stiff shoulders, numbness, dislocation, or difficulty moving limbs. Includes body diagram to mark affected area and severity scale.

Joint & muscle pain Injury type Numbness & stiffness Body diagram Severity scale
Open PDF form
Ophthalmology
眼科 問診票 — for eye pain, blurry vision, eye discharge

For blurry vision, eye pain, redness, discharge, floaters, double vision, dry eyes, or foreign object in the eye. Specifies which eye is affected.

Affected eye (left/right/both) Vision symptoms Pain & discharge Foreign body Medication list
Open PDF form
ENT (Ear, Nose & Throat)
耳鼻咽喉科 問診票 — for ear, nose, and throat concerns

For ear pain, hearing loss, ringing, dizziness, nosebleed, nasal congestion, sore throat, difficulty swallowing, or hoarse voice. Covers all three areas in one form.

Ear symptoms Nose symptoms Throat symptoms Dizziness Pollen allergy
Open PDF form
Obstetrics & Gynecology
産婦人科 問診票 — for women's health, pregnancy, menstrual concerns

For pregnancy check-ups, menstrual concerns, vaginal discharge, abnormal bleeding, or fertility consultations. Includes full menstrual history and pregnancy history sections.

Menstrual history Pregnancy status Abnormal bleeding Past pregnancies Fertility concerns
Open PDF form
Dental
歯科 問診票 — for toothache, gum issues, dental concerns

For toothache, gum pain, loose teeth, bleeding gums, lost fillings, jaw pain, or dental alignment concerns. Also includes past reactions to anesthesia or treatment.

Tooth & gum symptoms Past treatment reactions Anesthesia history Medication list Pregnancy status
Open PDF form

Emergency Reference

What to do in an emergency

Save this page or screenshot it before you need it. In an emergency, every second counts.

Emergency Numbers

119Ambulance & Fire
110Police
AMDA Medical Interpreter Hotline
03-6233-9266

Free English interpretation for clinic visits

English-Friendly ERs in Tokyo

  • St. Luke's International Hospital Chuo — 24hr ER, English staff
  • Tokyo Medical and Surgical Clinic Minato — English-speaking GPs
  • Keio University Hospital Shinjuku — International Medical Care Center
  • Higashi Fuchu Hospital Fuchu — nearest hospital to west Tokyo, some English support

Key Japanese Phrases

  • Please call an ambulance 救急車を呼んでください Kyukyusha wo yonde kudasai
  • I need a doctor 医者が必要です Isha ga hitsuyou desu
  • I have chest pain 胸が痛いです Mune ga itai desu
  • I am allergic to... 〜にアレルギーがあります ~ ni arerugii ga arimasu
  • Do you speak English? 英語を話せますか? Eigo wo hanasemasu ka?

Stay on the Line — Key Tips

  • Stay calm and speak slowly when calling 119
  • Give your address in full — have it written down in advance
  • Do not hang up until the operator tells you to
  • If the operator does not speak English, say: "Eigo wo hanasemasu ka?"
  • AMDA (03-6233-9266) offers free phone interpretation for clinic visits Monday–Friday 10:00–16:00 (closed public holidays)
  • #7119 — Not sure if you need an ambulance? Call this free number anytime for adult emergency consultation advice (available in most of Japan)
  • #8000 — After-hours children's health advice line. Call if your child is unwell and clinics are closed
  • Take a photo of this page to have it offline

Emergency Card

Your personalised emergency card

Select your conditions and allergies below. A printable emergency card will be generated in Japanese and English — ready to carry in your wallet or save to your phone.

Conditions

Allergies