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Inquiries Regarding Prostheses

About This Contact Form

  1. Responses sent by email from Imasen Engineering Corporation to customers are sent for the purpose of answering inquiries made by customers. Please do not use the contents of our response email, in whole or in part, for any other purpose.
  2. The personal data you share with us through this contact form is used to answer your inquiry as well as to improve our companyfs products and services.
  3. Required fields are marked with an asterisk (*). These fields must be included when the form is submitted, so we ask that you fill them in. If you are unable to fill them in correctly, the form cannot be submitted. All fields other than the required fields are optional.
  4. If you fill in the form using half-width katakana characters, the information might not display correctly, and submitting the form might not be possible. We ask that you avoid using half-width katakana characters when filling out the form.

Input Form

Enter your name.

Name input column

Enter your contact information.

Address and where to make contact input column

Comment input column

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