Application｜National University Hospital Medical Cooperation Network

Please be sure to understand and agree the following contents before clicking the “Agree & Apply” button for proceeding the application form.

1．Please fill out your answers for “Personal information” “Infectious disease information” “Medical facility information” and “Other information” of this website.
2．Decision will be made by the network administrative office if the application is accepted or not based on its submitted information.
3．When the office found that the application details are not appropriate to process, the office may decline the application.
4．When submitted details complied with our screening guidelines, then the network administrative office will recommend an appropriate member from our network based on information provided.
5．The application will be sent to the selected member, and they will screen the application there.
6．The selected member may request the applicant to provide additional medical information.
7．The selected member and the applicant (or the applicant's attending doctor) will work on specific details such as consultation or hospitalization schedules by exchanging further information.

1．Regardless of the suitability of the acceptance, information supplied by the applicants is used as reference for system improvement of the network.
2．When the application is successfully accepted, medical information such as treatment details provided at the selected member's institute is shared with the administrative office and is used as reference for system improvement of the network.
3．In the case of where necessary, for a decision making of acceptance or at a time of actual medical consultation, the patient information may be provided to an external medical institute not limited to the network members.

Agree & Apply