Home · 指さし問診カード

Clinic Card Maker — Say It in Japanese Without Speaking

Tick your symptoms, allergies and medications in English; get a clean bilingual card to show at the reception desk — the Japanese is written by a physician, not machine-translated. Print it, save it as a PDF, or just hold up your phone. Everything stays in your browser; nothing you type is sent anywhere.

1Who is the patient?

2Symptoms

Tick everything that applies.

Since when?

3Allergies

4Current medications & conditions

Medication names stay in English — generic names are understood internationally.

Existing conditions

This card replaces the language barrier, not the intake questionnaire — staff may still hand you a 問診票 and will help you through it. Japanese translations are fixed, physician-written pairs; your free-text entries appear in English with a note asking staff to read them. See also: what happens at a first visit · which clinic type you need.