Special Request Form

【 In order to make a reservation at the requested restaurant 】

We at My Concierge Japan have an extensive network and good relationships with restaurants and restaurant owners all across Japan and because of this can assist you in making reservations.

However, the more popular and high-profile the restaurant you have selected is, the more difficult it is to make a reservation. At times it will not be possible to do so.

A reservation can be made if seating is found to be available.
In such cases, we require that payment for the course(s) and the 10% concierge reservation fee is paid in advance in order to secure the reservation.

【 Please read carefully 】

*Reservations must be made at least one month in advance

*After seating availability is confirmed, online pre-payment for your meal is required in order to make a reservation.

*In cases the selected restaurant is highly difficult to book, or if the ingredients used there are seasonal/have to procured significantly in advance, we may ask that a deposit payment is made before we check for seating availability. The deposit will be fully refunded if seating is found to be unavailable.

*A 10% service fee plus consumption tax is required and will be added to your invoice.

*The payment deadline is witihin 48 hours after sending you the invoice. Your reservation will be cancelled if payment is not received.

【 Cancellation of reservations 】

A full refund is given for any cancellations made at least one week (7 days) before the date of the reservation.

Please note that any cancellations made within one week (6 days) of the reservation will be ineligible for a refund.

Name of restaurant*
Restaurant location *
Restaurant homepage URL
Date of reservation*

 
Time of reservation*
Number of people*
Adult
Child
Select Course
LunchDinner
Budget for course (per person)
Name*
  • First Name
  • Last Name
Sex
Country*
Hotel name or address of place of stay in Japan*
Emergency contact number (mobile phone)*
E-mail*
E-mail (Confirmation)*
Please be sure to check any that apply:*
【1】Someone has a food allergy in the reservation .【2】Someone in the reservation has a food that they dislike.【3】Someone in the reservation has a food that they cannot eat due to religious belief.【4】Everyone in the reservation can eat anything.【5】Due to an allergy, the restaurant cannot use the same oil that has been used to cook shrimp, crab or shellfish.
Any food allergies or food that you cannot eat:


※If anyone in your group has any allergies or special dietary requests, please list in as much detail what foods cannot be eaten and also the number of people that it applies to (if it is not listed then the dietary request will be applied to every member of the group).
※Please note that the restaurant will be unable to accommodate any sudden dietary requests made at the restaurant on the day of your reservation, therefore please make sure to list it here.

※ Please note that the food you cannot eat may be used to cook other customers' meals at the restaurant. Please let us know if the allergy is a serious or sensitive one (Is it okay if the restaurant uses the same oil to cook your food when cooking other customers food?)
Comments: (Ex. Guests with a disability, Special requirements or requests, Special occasion etc.)
How did you hear about us?

【Reservation Process】

  • After sending your request, you should receive an automated email entitled "About your reservation". Please read it carefully. For those that have not received an email after sending a request, please check your spam/junk inbox.
  • After seating availability is confirmed, online pre-payment for your meal is required in order to make a reservation. An email with a URL link for payment will be sent where you can make payment for your course. The payment deadline is 48 hours after sending you the invoice. Your reservation will be cancelled if payment is not received.
  • The total amount for your meal plus a 10% service fee and tax is required.
  • A full refund will be given for any cancellations made at least one week (7 days) before the date of the reservation. Please note that any cancellations made within one week (6 days) of the reservation will be ineligible for a refund.

Checklist of 5 questions to keep you safe from COVID-19.*

This is a checklist created in order to keep you and other dining guests, as well as the restaurant staff, safe from the spread of COVID-19. All measures below are strictly required to be kept by all guests and restaurant staff alike. Thank you for your understanding and cooperation.
Please check either of the ☑ below, select the current date and enter your full name.

A. Prior to the reservation date.

  1. I currently have a body temperature of 37.5°or higher.
  2. I have experienced one of the following symptoms in the last 14 days: fever / coughing / breathlessness / fatigue / impaired sense of taste.
  3. I have come in contact with a person who has experienced the above symptoms in the last 14 days.
  4. I have been to a country or area considered a Travel Warning Level 3 by the Ministry of Foreign Affairs of Japan in the last 14 days.
  5. I have been to or attended a facility, event or meeting (excluding public transportation) considered a cluster infection risk in the last 14 days.

I apply to none of the aboveI apply to one or more of the above

B. On the reservation date.

  1. I will wear a mask to the restaurant and will only remove it once I am seated
    YesNo
  2. I will disinfect my hands with the alcohol disinfectant placed at the entrance of the restaurant
    YesNo
  3. I understand social-distancing and the need for sufficient space between seats, and will refrain from actions such as talking too loud or too close to the others
    YesNo
  4. I agree to being refused entry to the restaurant if my body temperature exceeds 37.5°when it is measured by the restaurant staff at the restaurant.
    YesNo

I hereby certify that the above information is true and correct. I agree to cancel my reservation (or be refused entry) if there is any discrepancy regarding the above with any member of my party on the day of the reservation. I fully understand that it is my responsibility to inform all other members of my party of the above and to contact My Concierge Japan in order to facilitate a cancellation or alteration to the reservation if there is any member that applies to one of the points above.
I agree to the Cancellation Policy in regards to refunds due to any cancellation or refusal of entry.

  • Please confirm that your email address is correct. After pressing send, you should receive an email shortly. If you do not receive an email, please check your spam/junk folder.
  • In cases the selected restaurant is highly difficult to book, or if the ingredients used there are seasonal/have to procured significantly in advance, we may ask that a deposit payment is made before we check for seating availability. The deposit will be fully refunded if seating is found to be unavailable.
  • By sending this message, I agree to the privacy policy and all of the terms above.

My Concierge Japan works with highly recommended restaurants in Japan, so that visitors can easily make reservations online.

My Concierge Japan is a reservation customer support service that works with concierge recommended restaurants. We work directly with restaurants, and make their official website available in multiple languages so reservations and inquiries can be made online for visitors from around the world. The web pages are continuously updated with the latest information.