Contact

Address

〒150-0043 Tokyo, Shibuya City, Dōgenzaka, 1-chōme−10−8
SHIBUYA DOGENZAKA TOKYU BLDG 2F−C

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Full Name
E-mail
Address (Please include the country and zip code.)
Phone number
Please tell us your concerns or questions you would like to discuss at the session.
If you or your client are/is feeling like seriously hurting yourself or others at the time of filling out this form or during the course of the sessions, instead of contacting us please contact emergency medical services to receive help immediately. Please select whether you agree to this condition for receiving services. If you do not select the "Yes, I Agree" option, your appointment will be cancelled.: Yes, I agree with the condition.No, I don't agree with the condition, and will not make an appointment with KPCS.