The Bluff Clinic

The Bluff Medical and Dental Clinic is an organization established to provide quality medical and dental care to the members of the community living in Yokohama and Tokyo area.

    First-Aid training course support request form

    Your Name (required)

    Your Email (required)

    Your organisation name (required)

    Your Message/Explanation

    Expected starting date of the course

    (Format YYYY-MM-DD):

    Length of the course in hours :

    Length of the course in days :

    Number of expected participants :

    Price of the course to the participants :

    Your association official registration (if available)

    For reporting back to the clinic on the use made by the funds provided, please download, fill out the form and return it to
    Open Office version:
    PDF version :

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