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Treatment for Non-Japanese Speakers starts from ¥33,000 (Deposit: ¥11,000). Please proceed if this works for you. |
Easily Book Your Dental Visit in Tokyo by Google Forms

Prefer to communicate in English via forms?
You can book your appointment at Sakura Platinum Dental Clinic directly through Google Forms .
Our English-friendly support (via translation app) ensures smooth communication, even if you don’t speak Japanese.
Step-by-Step: How to Book via Google Forms
1. Access the Google Forms
2. Fill out the form
Please fill out the Google Forms with the required information and 3 possible dates and times for your visit.
3. Receive the provisional appointment by email & Pay the deposit to confirm your booking.
Once you receive the provisional appointment by email or chat (We typically reply within 30 minutes — up to 3 hours depending on the situation.Please check your spam folder just in case.), pay the deposit by the deadline to confirm your booking .
Deposit Payment Deadline |
based on your provisional appointment time |
【24H+】pay within 3h of opening / 6h of message |
【<24H】pay within 1h of opening / 2h of message |
Note: If anything changes—even after sending your request, receiving a provisional appointment, or confirming your booking—please contact us as soon as possible.
For details including the sender’s email address, please refer to the Google Forms.
Non-Japanese Speakers Fee Start from ¥33,000
Treatment starts from ¥33,000. |
After an in-person diagnosis, we will clearly explain the fees. [Services & Fees] |
If you do not have Japanese health insurance or cannot communicate in Japanese, treatment will be private care, starting from ¥33,000.
A ¥11,000 deposit is required by the deadline. |
Secures your spot, fully applied to treatment, refundable (minus processing fees) if canceled 24h in advance. [About Deposit] |
Kindly proceed with your booking or inquiry only if you're comfortable with the above.
Booking is Confirmed After Deposit Payment
To secure your appointment, we kindly ask non-Japanese speaking patients using chat or form-based bookings to pay a ¥11,000 deposit by the deadline.
Your booking is confirmed only after the deposit is completed.
▶︎Request (with 3 preferred dates) ▶︎Get provisional time & payment link ▶︎Pay deposit ▶︎Booking confirmed
AMOUNT ¥11,000 | Required for WhatsApp, LINE, and Form bookings. Not required for instant booking in English via the Japanese reservation site. |
PURPOSE | To secure your appointment — fully applied to your treatment fee. |
PAYMENT DEADLINE | (based on your provisional time) 【24H+】pay within 3h of opening / 6h of message 【<24H】pay within 1h of opening / 2h of message |
REFUND | ・Full refund (minus card fee) if canceled 24h in advance ・No refund within 24h or for no-shows — deposit becomes cancellation fee. |
→For more about Deposit |
Booking Policies
Confirmation & Cancellation Policy | Arrival Policy |
If you don’t show up without notice, or cancel less than 24 hours before your appointment, a ¥11,000 cancellation fee will apply. If you’ve already paid a deposit, it will be used as the cancellation fee. Future bookings may be restricted. If you need to reschedule, we may not always be able to accommodate, but please let us know as soon as possible via the same method we’ve been using. | If you arrive more than 10 minutes late without notice, we may not be able to provide treatment. If you expect to be more than 5 minutes late, please contact us in advance so we can adjust the schedule accordingly. |
We appreciate your cooperation in ensuring smooth dental care services.
Start Booking Now
Prefer Instant Booking or chats?
If you’d rather book instantly or prefer chats, check out our Complete Booking Options Page.
Instant Booking
Book or contact via WhatsApp or LINE
Sakura Platinum Dental Clinic (Shibuya, Tokyo) | |
![]() | ✓ 1 min from Shibuya Station — one of Tokyo’s most accessible hubs ✓ Open daily 12PM–5AM (until 2AM for international patients) ✓ English & multilingual support via app ✓ Gentle, pain-conscious treatment ✓ Online booking available (instant booking options too) |
Ready to Book
Open Daily 12PM–5AM / 1 min from Shibuya Station
Instant Booking | Book & Ask | Book & Ask |
Japanese form, with English Guide | Google Forms (Email Confirmation) | WhatsApp or LINE |
English & multilingual support (via app) / Private care for non-Japanese speakers from ¥33,000.