2020 Physician/Dentist/Pharmacist Notification Form, Request for Notification of Public Health Nurse/Midwife/Nurse/Associate Nurse/Dental Hygienist/Dental Technician

Licensed doctors, dentists, pharmacists, and public health nurses, midwives, nurses, assistant nurses, dental hygienists, and dental technicians who are engaged in their work are subject to relevant laws and regulations, as of December 31 of every other year. It is obligatory to report matters such as the name, address, place of work, etc. This year is the implementation year, so please be sure to submit a notification if you are applicable.

1 Notification Obligor

[Doctors, dentists, pharmacists]

All license holders
Those who work at medical institutions or pharmacies can apply online.

[Public health nurses, midwives, nurses, assistant nurses, dental hygienists, dental technicians]

Those who are engaged in business in Tokyo as of December 31, 2022
This applies even if you are on vacation and have an employment relationship.

2 Online notification

If you wish to report online, please check the website of the Ministry of Health, Labor and Welfare.

Ministry of Health, Labor and Welfare homepage (about report (report of third teacher, report of duties worker) once in two years by medical worker) (link to the outside site)

Ministry of Health, Labor and Welfare homepage (medical worker report system) (link to the outside site)

3How to distribute notification slips

Distributed at public health centers. It can also be downloaded from this website (see below), the website of the Ministry of Health, Labor and Welfare, and the website of the Tokyo Metropolitan Government. You can download notification slips in PDF, Word, or Excel from the websites of the Ministry of Health, Labor and Welfare and the Tokyo Metropolitan Government.
In addition, the previous forms (2020) and earlier cannot be used for all occupations. Please be careful not to submit old notification slips.

Ministry of Health, Labor and Welfare homepage (we link to the outside site)

Tokyo homepage (we link to the outside site)

4 Deadline for notification

January 16, 2020 (Monday) [common to all occupations]

5 Where to report

[Doctors, dentists, pharmacists]

In principle, the public health center that has jurisdiction over the place of residence
It is also possible to compile the information at the place of employment and submit it to the public health center that has jurisdiction over the place of employment.
Those who work at medical institutions or pharmacies can apply online.

[Public health nurses, midwives, nurses, assistant nurses, dental hygienists, dental technicians]

Public health center that has jurisdiction over the place of employment
It is also possible to collect and submit at your place of employment.
The public health center that has jurisdiction over your address will not accept it.

Notification slip download

1 Doctor report vote (PDF: 576KB)
Doctor notification form (word: 154KB)
Doctor notification form (Excel: 55KB)
Doctor notification form (entry example) (PDF: 274KB)
Doctor's notification form (entry procedure) (PDF: 575KB)
2 Dentist notification form (PDF: 390KB)
Dentist notification form (word: 127KB)
Dentist notification form (Excel: 37KB)
Dentist notification form (entry example) (PDF: 230KB)
Dentist notification form (instructions) (PDF: 388KB)
3 Pharmacist notification form (PDF: 182KB)
Pharmacist notification form (word: 112KB)
Pharmacist notification form (Excel: 34KB)
Pharmacist notification form (entry example) (PDF: 195KB)
Pharmacist report form (entry point) (PDF: 199KB)
Four

Public health nurse, midwife, nurse, assistant nurse duties worker report (PDF: 807KB)
Public health nurse, midwife, nurse, assistant nurse notification (Excel: 62KB)

Five

Dental hygienist business worker report (PDF: 456KB)
Dental hygienist business worker report (Excel: 29KB)

6

Notification of Dental Technician (PDF: 426KB)
Notification of Dental Technician (Excel:28KB)

Q&A about notification

Q: What is this report used for?
A: The purpose of this survey is to understand the distribution and employment status of medical professionals and to obtain basic data for medical administration.

Q: My current address and resident card are different. Which one should I write?
A: Please enter your current address.

Q: I am a licensed nurse, but I am not currently working. Do I need to report it?
A: No. Public health nurses, midwives, nurses, assistant nurses, dental hygienists, and dental technicians do not need to report if they are not engaged in work.

Q: I work as both a public health nurse and a nurse.
A: Please fill in the registration numbers of both public health nurses and nurses and the date of registration, and notify the main work as a public health nurse.

Q: I have a license as a public health nurse, midwife, or nurse, but what should I do if I am only working as a nurse?
A: Please fill in the registration number and registration date of all licenses, and notify the main work as a nurse.

Q: How do I calculate the number of hours worked per week for part-time workers?
A: If you select a part-time worker in the public health nurse, midwife, nurse, or assistant nurse notification form, the number of hours worked per week (e.g. 8 hours a day x 3 times a week) = 24 hours work per week).

Q: I have been working at facility A for 5 years and 9 months now. For five years before that, I worked at B Hospital, which is set up by the same corporation. How should I write the period of employment in that case?
A: It will be 10 years and 9 months because we continue to work at the facility of the same installer.

Go to Adobe Acrobat Reader download page

Adobe Acrobat Reader is required to view PDF format files. If you do not have Adobe Acrobat Reader, please download it for free from the link in the banner.

inquiry

Health and Sanitation Section, Minato Public Health Center 5F, 1-4-10 Mita, Minato-ku, 108-8315 Phone: 03-6400-0044

Back to blog