Name*
*Please register using the same name as shown on your insurance card for coordination with medical institutions
Name in Kana*
Date of Birth*
Sex*
Contact Information*
Address*
Login Information*
* Minimum 8 letters & numbers
Contractor*
Plan
Wellness Membership Standard
This is an annual contract plan.
It will be automatically renewed.
Regular Price
For 1 installments
Save 1 month's worth
￥605,000（Tax Included）
For 12 installments
￥55,000 × 12Months（Tax Included）
￥660,000（Tax Included）
Number of Payments*
Coupon
ANA Mileage
You will earn 1 mile for every 100 yen (tax included) on your first year payment.This campaign is only available for those who enter their mileage number during registration.※ Cannot be used with coupons.
Total Payment*
Payment Method*
Terms and Conditions*
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