Update date: April 1, 2024
Notes
- It is in PDF file format, so please print it out and use it. Plain paper and A4 or B5 print sizes are recommended. Do not use thermal paper or backing paper.
- Please use a black ballpoint pen or black ink (do not use an erasable ballpoint pen).
- Rubber seals and stamps cannot be used when a seal is required.
Pregnancy notification form, etc.
Pregnancy notification form (PDF: 626KB)
Pregnancy notification form (entry example) In the case of notification by the pregnant woman herself (PDF: 802KB)
Pregnancy notification form (entry example) In the case of notification by someone other than the pregnant woman (PDF: 811KB)
Pregnancy notification proxy (PDF: 55KB)
Pregnant woman health checkup consultation fee subsidy and newborn hearing examination consultation fee subsidy application relationship
Consultation expenses subsidy grant application (PDF: 85KB)
Example of filling out application form for medical treatment fee subsidy (PDF: 401KB)
Consultation expenses subsidy bill (PDF: 81KB)
Example of how to fill out a medical consultation fee subsidy request form (PDF: 164KB)
Specific infertility treatment medical expenses subsidy application related
Inagi City Specified Infertility Treatment Medical Expense Subsidy Application Form (Medical Expenses for Advanced Medical Infertility Treatment, etc.) (Form No. 1) (PDF: 282KB)
Example of filling out the Inagi City Specified Infertility Treatment Medical Expense Subsidy Application Form (Medical Expenses for Advanced Medical Infertility Treatment, etc.) (Form No. 1) (PDF: 387KB)
Inagi City Specified Infertility Treatment Medical Expense Subsidy Project Certificate of Consultation (Medical Expenses for Advanced Medical Infertility Treatment, etc.) (Form No. 2) (PDF: 127KB)
Inagi City Specified Infertility Treatment Medical Expense Subsidy Project Certificate of Consultation (Advanced Medical Infertility Treatment, etc. Medical Expenses) (Form No. 2) Example (PDF: 254KB)
Inagi City Specified Infertility Treatment Medical Expenses Subsidy Request Form (Medical Expenses for Advanced Medical Infertility Treatment, etc.) (Form No. 4) (PDF: 79KB)
Example of filling out the Inagi City Specified Infertility Treatment Medical Expenses Subsidy Request Form (Medical Expenses for Advanced Medical Infertility Treatment, etc.) (Form No. 4) (PDF: 170KB)
Inagi City Specific Infertility Treatment Subsidy Application (Advanced Medical Treatment Infertility Treatment, etc. Medical Expenses) Document Submission Checklist (PDF: 107KB)
Inagi City specific infertility treatment subsidy application (for medical expenses such as advanced medical infertility treatment) de facto marriage petition form (entry example) (PDF: 261KB)
Adobe Acrobat Reader DC (formerly Adobe Reader) is required to open PDF format files.
If you don't have it, you can download it for free from Adobe.
Download Adobe Acrobat Reader DC
