Samples / materials

For doctor use only Request for AK samples / materials

Samples and materials are available. Please inquire by phone, fax, or email.

Inquiry by phone

0120-9407-62

Reception hours: Weekdays, 9 AM to 5 PM

Inquiry by fax or email

Please send a fax:0120-78-6010 or email:info@rosette.jp containing the following information. (24-hour service.)

[Information] *Asterisks indicate necessary information.

  1. Are you requesting AK samples / materials? Yes / No
  2. Hospital name*
  3. Furigana
  4. Medical department or field*
  5. Your name*
  6. Furigana
  7. Postal code of the destination clinic*
  8. Address of the destination clinic*
  9. Telephone number of the destination clinic*
  10. Fax number
  11. Email address
  12. How did you learn of this website?
    Magazine or newspaper / Direct mail / Acquaintance / Search engine / Medical Asahi / Academic conference / Other
  13. Did you know of our company? Yes / No
  14. Did you know of AK? Yes / No
  15. Comments, requests, etc.