HIV Testing Consultation Service for Foreign Residents
Reservation Form (Setagaya Public Health Center)

Select your language

Select your time frame

请选择您希望的时间

Bạn hãy lựa chọn thời gian mong muốn

Questions

I agree with the above terms before applying.

Are you the person taking the test?

Can you come on both the test and the result explanation date?

Test date: July 17 (Thu) 10:00~10:15
Result Explanation Date: July 24 (Thu) 9:30~10:15

What is your native language?

What is your nationality?

How long have you been in Japan?

Do you need an interpreter?

Have you had any reaction to alcohol disinfection?

Have you ever felt unwell after taking a blood test?

Is there anything you would like to ask or know more about?

How did you learn about this testing event? (multiple answers allowed)

Enter your email address

请输入您的电子邮件地址

Vui lòng nhập địa chỉ email của bạn