Discover (Booking) - LUMINA JAPAN

Personal Information

First Name

Last Name

Nationality

Country of Residence

Email

Travel & Visit Details

Preferred Travel Dates

Estimated Length of Stay

Number of Travelers

Estimated Budget per Week (USD)

Purpose of Visit

Medical Treatment (Health Check-Up, Cancer Care, Regenerative Medicine, Aesthetic Medicine)

Wellness Retreat (Hot Springs, Zen, Mindfulness, Nature Healing)

Culture & Tradition (Tea Ceremony, Temples, Crafts)

Culinary Experiences (Fine Dining, Local Cuisine)

Others (Please Specify)

Medical / Wellness Preferences

Preferred Program Type

Health Background

Interpreter or Accompaniment Required?

Yes - Full-time support

Yes - Occasional support

No

Not sure yet

Communication & Additional Details

Preferred Method of Contact

Email

Online Meeting (Zoom / Teams etc.)

Other

How Did You Hear About LUMINA JAPAN?

Referral from a friend or family member

Referred by a healthcare professional

Introduced by a concierge or private assistant

Social media (Instagram, Facebook, etc.)

Online search (Google/Bing)

Press articles or media coverage

Luxury travel or wellness community

Events or conferences

Other

Additional Comments or Requests

Consent

I agree to the Privacy Policy and the use of my personal data for travel and medical coordination purposes.

Inquiry Form

Personal Information

Travel & Visit Details

Medical / Wellness Preferences

Communication & Additional Details

Ready to rejuvenate in Japan?