You can apply for clinical study consultation here, by either e-filing the form or by downloading the MS Word file and sending it to the following address by mail.

J-SUPPORT Administrative Office, Supportive Care Development Center, National Cancer Center Hospital

5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan

Application Form for Clinical Study Consultation (Word file, .docx 32 KB)

* When the form is e-filed, attachments need to be sent to the J-SUPPORT Administrative Office by mail.

Application Form for Clinical Study Consultation

(※): All fields marked with an asterisk (※) are required.

Applicant name (※)
Description of research (※)
Affiliation (※)

State the name of your institution and department.

Phone number (※)
Email address (※)
Articles published with you as the first or corresponding author and cited in PubMed (※)

If you have ≥ 1 article about clinical research, check “Yes”. Otherwise, check “No”.

Articles published with you as the first or corresponding author and cited in PubMed (※)
Type of research (※)
Content of consultation (※)


For those who checked “Other”, specify the content of consultation in the “Questions & consultation objectives” below.

Planning stage (※)
Title of research (※)

Input the title of your research project.

Questions & consultation objectives (※)

Write questions and consultation objectives in detail.

Attachments (※)

Attachments (for “Other”) 
Preferred response method (※)


Preferred response method (for “Other”) 
Preferred day of the week (※)



Preferred time of the day (※)

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