Our Referral Network – When You Need Specialist Care in Tokyo

SAKURA International Clinic Asakusa is a general internal medicine clinic. We treat a wide range of everyday health concerns — from fevers and stomach problems to allergies and minor injuries. However, some conditions require specialist expertise that goes beyond what a general clinic can provide.

When that happens, we don’t leave you on your own. We write a referral letter (紹介状 / shoukaijou) to an English-friendly specialist or hospital in Tokyo, so you can get the advanced care you need without the language barrier.

How Referral Letters Work in Japan

Japan’s healthcare system is built around a referral structure. Large hospitals and specialist clinics expect patients to arrive with a referral letter from a primary care doctor. This letter contains your medical history, examination findings, and the reason for referral — all written in a format that Japanese specialists understand.

At SAKURA International Clinic, we prepare your referral letter in both English and Japanese, ensuring smooth communication between you and your specialist.

Referral Letter Fee

The cost for a referral letter is ¥11,000 (tax included), in addition to the consultation fee. This covers the preparation of a bilingual document and coordination with the receiving facility.

When Do You Need a Referral?

Here are the most common situations where we refer patients to specialists. If you’re unsure whether your condition requires a referral, come see us first — we’ll assess your situation and advise you on the best next step.

Fractures & Severe Injuries → Orthopedic Surgery

If you’ve broken a bone, dislocated a joint, or suffered a serious sports injury, you need an orthopedic specialist. We can perform an initial assessment, provide pain relief, and refer you to an orthopedic clinic with English-speaking staff for X-rays, casting, or surgery.

Dental Problems → Dentistry

Toothaches, broken teeth, and dental emergencies require a dentist. We’ll refer you to an English-friendly dental clinic in the Tokyo area. For severe dental infections causing fever or swelling, we can prescribe antibiotics before your dental appointment.

Eye Problems → Ophthalmology

Eye infections, sudden vision changes, eye injuries, and contact lens complications need specialized equipment and expertise. We’ll connect you with an ophthalmologist who can communicate in English.

Mental Health → Psychiatry & Psychosomatic Medicine

If you’re experiencing anxiety, depression, panic attacks, or other mental health concerns, we can refer you to a psychiatrist or psychosomatic medicine specialist. Finding English-speaking mental health professionals in Tokyo can be challenging on your own — our network makes it easier.

Gynecological Issues → Gynecology

For gynecological examinations, pregnancy-related concerns, or reproductive health issues, we refer to trusted gynecologists who provide care in English. We understand these are sensitive matters, and we ensure you’ll be in comfortable, professional hands.

Conditions Requiring Hospitalization → General Hospital

If your condition requires inpatient care — severe dehydration, serious infections, chest pain, or any condition that needs continuous monitoring — we’ll arrange a referral to a major hospital with international patient services.

Advanced Imaging (MRI / CT Scan) → General Hospital

When we suspect a condition that requires MRI, CT scan, or other advanced diagnostic imaging, we’ll refer you to a hospital equipped with these facilities. Our referral letter will specify exactly what imaging is needed, streamlining your visit so you won’t face unnecessary delays.

Surgical Cases → Specialist Hospital

If surgery is needed — whether it’s appendicitis, gallstones, or another surgical condition — we’ll refer you to an appropriate surgical facility with English-speaking medical staff who can walk you through the entire process.

Specialized Skin Conditions → Dermatology

While we can handle common skin rashes and minor allergic reactions, conditions requiring specialized dermatological treatment — such as severe eczema, psoriasis, or suspicious moles — need a dermatologist’s expertise. We’ll refer you to a clinic with the right equipment and English support.

Why a Referral Letter Saves You Money

Here’s something many visitors don’t know about Japan’s healthcare system: if you walk into a large hospital without a referral letter, you’ll be charged an additional fee of ¥5,000 to ¥7,000. This surcharge is called 選定療養費 (sentei ryouyouhi) and applies to hospitals with 200 or more beds. It’s designed to encourage patients to visit primary care clinics first, rather than going directly to large hospitals for non-emergency conditions.

With a referral letter from our clinic, this surcharge is completely waived. So the ¥11,000 referral letter fee effectively saves you money while also ensuring better, more coordinated communication between your doctors.

The Referral Process – Step by Step

  1. Visit our clinic first. We’ll examine you, run any necessary initial tests, and determine whether you need specialist care.
  2. We prepare your referral letter. This bilingual document (English + Japanese) includes your symptoms, examination findings, test results, and our clinical assessment.
  3. We help coordinate your appointment. We’ll recommend an appropriate specialist and, when possible, assist with scheduling your visit.
  4. You visit the specialist. Bring your referral letter, passport, and insurance documents. The specialist will already have full context about your condition.

The entire process is designed to be as seamless as possible. You won’t need to explain your medical history from scratch at the specialist’s office — it’s all in the referral letter.

Start With Us – We’ll Guide You From There

Not sure if you need a specialist? That’s exactly why we’re here. Come to SAKURA International Clinic first, and we’ll assess your situation. If specialist care is needed, we’ll make sure you get to the right doctor with full English support. If it’s something we can handle in-house, we’ll treat you on the spot.

Don’t navigate Tokyo’s medical system alone. Let us be your first point of contact.


SAKURA International Clinic Asakusa

  • 1-minute walk from Asakusa Station
  • Open daily 9:00–17:00 (365 days a year)
  • Languages: English / Chinese / Korean / Japanese
  • Consultation: ¥55,000 all-inclusive / Referral letter: +¥11,000

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Medical Disclaimer: The information provided on this website is for general educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider. In case of emergency, call 119 (Japan).