If you have a fax referral | Ehime University Hospital

Medical Examinations

If you have a fax referral

Did you know? With a referral from your family doctor you can make an appointment for your consultation.

If you have already attended your family doctor or local hospital/clinic, we recommend that you use our “fax consultation reservation system” with your “family doctor referral” if you need to attend Ehime University Hospital. A referral letter will exempt you from the part of initial consultation fee charged to you (¥5,400 includ. Consumption tax) and will enable you to make an appointment for a specific date and time. This appointment reservation obviates the need to attend the hospital in advance to fill out examination application forms, and it will shorten waiting times. We hope that you will avail of the benefits of this system.
  • When your doctor has determined that you need close scrutiny and treatment at Ehime University Hospital, he must explain this to you and get your consent.
  • (After you have consented)the family doctor fills out a “Fax Transmission Form” (PDF / MS WORD)and faxes it to the Ehime University Consultation Support Center. If the local clinic has its own format, this can be used as well.
  • On receipt of the fax, a member of staff at the Ehime University Consultation Support Center will read the form and check the schedules of specialists and doctors in relevant departments, and make an appointment for you. We strive to set up the appointment within 20 minutes of receipt of the fax.
  • Once the appointment is set up, we send an “Appointment Confirmation” by fax to the referring doctor and issue a patient card by the date of the appointment. You should arrive at the hospital approximately 15 minutes before the appointment. When you have an appointment there is no need to come to the hospital early in the morning and wait to see the doctor.
  • Please bring the following items when you come for your appointment:
    • Referral letter(consultation report)
    • Appointment Confirmation
    • Insurance card
    • Any public assistance cards, or treatment cards, such as childcare treatment or rehabilitation.
  • When you arrive at the hospital, please proceed to the “General Reception ① Initial Consultation” Desk.
  • Please hand your referral letter, insurance card and appointment letter to the receptionist at the “General Reception ① Initial Consultation” Desk. If you have a family doctor referral fax appointment but you do not have your appointment letter with you, please give your name and inform the receptionist that you have a fax appointment.
  • Please take your patient card, payment ticket etc and proceed to the outpatients reception in the relevant department.
  • Please contact the Consultation Support Center if you are not able to attend at the designated time.
TEL:089-960-5322(Direct)  FAX:089-960-5959(Direct)

Ehime University Hospital “Fax Transmission Form” can be downloaded here

Application of PDF utilization can be downloaded for free from Adobe.
It is linked from here.(It will open in a new window.)