妊娠の悩み相談窓口 にんしんSOSとちぎ

日本語

Consultation form

Consultation form

Please fill out the form and click the "Confirm" button at the bottom.
Please note that you will not be able to send the form if the required items are not filled in.

Telephone consultation

Tuesday 10:00~14:00
Saturday 14:00~18:00

Your name(Nickname allowed)
Age years old
Address
Municipality:
Municipality:
E-mail address
Confirm E-mail address
Phone number
Preferred contact method

※ If you would like us to call you, please register your phone number. You will be contacted during business hours.

Tues:10:00~14:00 Saturday:14:00~18:00

Pregnancy status
Delayed menstruation
Expected date of birth
Weeks of pregnancy About weeks
Date of last period
Job
学校の種類:
ご職業・状況:
Partner
Pregnancy history
Number of pregnancies:
Of which, number of births:
Of which, the number of spontaneous miscarriages:
Of which, the number of abortions:
What is your problem or what do you want to consult us about?

When sending using the email address of a mobile phone or smartphone

(@docomo.ne.jp、@ezweb.ne.jp、@softbank.ne.jp、@y-mobile.ne.jp etc.)

If you use the email address of your mobile phone or smartphone, the inquiry reception email may not arrive. Please register your computer's email address or set your mobile phone or smartphone to receive emails from your computer.
※For the setting method, please contact each mobile phone company.

If there is no mistake in the above contents, Click the "Confirm" button below.

About us

Tochigi Midwives Association
451-1 Sakitama, Nasushiobara city, Tochigi , 325-0033
TEL 080-9662-1103