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{"sheet":"2026年度　企業情報シート","index":0,"n_rows":50,"n_cols":35,"rows_kept":50,"cut":false,"hidden":false,"merged":[[4,0,4,34],[6,22,6,26],[43,1,43,33],[23,4,23,34],[24,4,24,34],[38,0,38,34],[39,0,39,34],[42,0,42,34],[31,10,32,17],[31,18,32,20],[36,0,36,34],[33,4,34,34],[27,0,28,3],[27,4,28,9],[27,10,28,17],[31,0,34,3],[27,21,27,26],[27,27,27,34],[27,18,28,20],[32,21,32,34],[29,0,30,3],[29,4,30,9],[29,10,30,17],[29,18,30,20],[30,21,30,34],[29,27,29,34],[29,21,29,26],[31,21,31,26],[31,27,31,34],[31,4,32,9],[28,21,28,34],[10,0,10,3],[10,4,10,16],[10,17,10,20],[10,21,10,34],[15,8,15,9],[15,10,15,11],[15,12,15,13],[15,14,15,15],[15,16,15,17],[11,4,11,16],[11,0,11,3],[12,0,13,3],[0,0,0,24],[0,25,0,34],[8,6,8,11],[2,22,2,24],[2,25,2,27],[2,29,2,30],[2,32,2,33],[6,0,6,3],[6,27,6,34],[7,0,7,3],[7,27,7,34],[8,0,9,3],[8,4,8,5],[9,4,9,34],[6,4,6,21],[7,4,7,21],[15,0,15,3],[15,4,15,5],[15,6,15,7],[15,18,15,19],[15,20,15,23],[11,17,11,20],[11,21,11,34],[12,17,13,20],[12,21,13,34],[19,4,19,34],[15,24,15,34],[18,0,18,8],[18,9,18,34],[16,0,16,3],[16,4,16,34],[19,0,25,3],[20,4,20,34],[21,4,21,34],[22,4,22,34]]}
["2026年度　企業情報シート　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【協会けんぽ専用】"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お申込日：",null,null,null,null,null,"年",null,null,"月",null,null,"日"]
[]
["※保険者番号と保険証記号が必ず同一の企業ごとにお申込ください。"]
["▼お客様情報",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「受診者名簿」もご記入ください。"]
["フリガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"申込人数",null,null,null,null,"予約希望月（例：7月～9月）"]
["事業所名"]
["住所",null,null,null,"（〒",null,"ー",null,null,null,null,null,null,"）"]
[]
["フリガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"TEL",null,null,null,"ー　　　　ー"]
["ご担当者名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX",null,null,null,"ー　　　　ー"]
["ご担当者\nメールアドレス",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ご担当者\n連絡先",null,null,null,"ー　　　　ー"]
[]
[]
["保険者番号",null,null,null,0,null,1,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険証記号"]
["保険者名称",null,null,null,"全国健康保険協会 　　　　 支部"]
[]
["▼自己負担額のお支払方法",null,null,null,null,null,null,null,null,"※新規の事業所様につきましては、原則「全て窓口支払」のみとさせていただきます。\n※人間ドックのお支払いは「1 全て窓口支払」または「２ 全て事業所請求」のいずれかの方法のみのご案内となります。"]
["原則 1~4を\nお選びください",null,null,null,"　１　全て窓口支払"]
[null,null,null,null,"　２　全て事業所請求（本申込書に記載のない検査を追加した場合も事業所請求）"]
[null,null,null,null,"　 3　基本健診・一般健診のみ事業所請求、その他は窓口支払"]
[null,null,null,null,"　 4　基本健診・協会けんぽ補助（一般健診・節目健診・子宮がん検診・乳がん検診・骨密度検診）\n　　  のみ事業所請求、その他は窓口支払"]
[null,null,null,null,"　 5　その他　"]
[]
[]
["▼郵送物の送付先"]
["事前送付物\n(受診票・検査キット)",null,null,null,"　1  事業所へ\n ",null,null,null,null,null,"2  受診者自宅へ\n （住所情報もお送りください）",null,null,null,null,null,null,null,"３ その他\n ",null,null,"（〒    　　   -    　　   　）"]
[]
["個人結果",null,null,null,"　1  事業所へ\n ",null,null,null,null,null,"2  受診者自宅へ\n",null,null,null,null,null,null,null,"３ その他\n ",null,null,"（〒    　　   -    　　   　）"]
[]
["請求書\nおよび\n事業所用控え",null,null,null,"　1  事業所へ\n ",null,null,null,null,null,null,null,null,null,null,null,null,null,"２ その他\n ",null,null,"（〒    　　   -    　　   　）"]
[]
[null,null,null,null,"請求書は通常、月末締め・翌月20日前後の発送です。事業所用控えは法定項目のみ※1を発行します。\n法定項目以外の結果を新たに記載する場合は契約書の取り交わしが必要ですのでお申し出ください※2。\nなお、全て窓口支払の場合は事業所用控えは発行いたしません。"]
[]
[]
["※１　法定項目とは、労働安全衛生規則第44条等に明記された健診項目です。"]
[]
["※２　法定項目以外も事業所様控え用結果票に通知する場合は貴社にて全受診者様から同意を得ていただくことが、厚生労働省「事業場における労働者の"]
["    健康情報等の取扱規程を策定するための手引き」に明記されています。"]
[]
[]
["【お申込み方法】メールでのお申込みのみになります。"]
[null,"『企業情報シート』と『受診者名簿』に必要事項をご入力の上、Excelデータをメールにてお送りください。\n【申込書送付先】　Mail：kenshin@sakurajyuji.jp\n※申込書送付後、2週間経っても連絡がない場合はおそれいりますが、お電話にてお問い合わせください。"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"〒860-0833 熊本県熊本市中央区平成3-23-30 サンリブシティくまなん3階"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX：096-378-1213／電話：0570-550-182 （受付時間：平日9:00～16:30 ）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"メール：kenshin@sakurajyuji.jp"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"※ご記入に際し、ご不明な点などはお気軽にお問い合わせください。"]

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["2026年度　企業情報シート　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【協会けんぽ専用】"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お申込日：",null,null,2026,null,null,"年",3,null,"月",1,null,"日"]
[]
["※保険者番号と保険証記号が必ず同一の企業ごとにお申込ください。"]
["▼お客様情報",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「受診者名簿」もご記入ください。"]
["フリガナ",null,null,null,"イリョウホウジンサクラジュウジ　メディメッセサクラジュウジクリニック",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"申込人数",null,null,null,null,"予約希望月（例：7月～9月）"]
["事業所名",null,null,null,"医療法人桜十字　メディメッセ桜十字クリニック",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"30人",null,null,null,null,"10～12月 "]
["住所",null,null,null,"（〒",null,"860　ー　0833　",null,null,null,null,null,null,"）"]
[null,null,null,null,"熊本県熊本市中央区平成3-23-30サンリブシティくまなん3階"]
["フリガナ",null,null,null,"サクラ　ジュウジロウ",null,null,null,null,null,null,null,null,null,null,null,null,"TEL",null,null,null,"0570ー550ー182"]
["ご担当者名",null,null,null,"桜　十字郎",null,null,null,null,null,null,null,null,null,null,null,null,"FAX",null,null,null," 　096ー378ー1213"]
["ご担当者\nメールアドレス",null,null,null,"jyujirou@sakurajyuji.com",null,null,null,null,null,null,null,null,null,null,null,null,"ご担当者\n連絡先",null,null,null,"080ーXXXXーXXXX"]
[]
[]
["保険者番号",null,null,null,0,null,1,null,4,null,3,null,0,null,0,null,1,null,6,null,"保険証記号",null,null,null,12345678]
["保険者名称",null,null,null,"全国健康保険協会 　熊本　支部"]
[]
["▼自己負担額のお支払方法",null,null,null,null,null,null,null,null,"※新規の事業所様につきましては、原則「全て窓口支払」のみとさせていただきます。\n※人間ドックのお支払いは「1 全て窓口支払」または「２ 全て事業所請求」のいずれかの方法のみのご案内となります。"]
["原則 1~4を\nお選びください",null,null,null,"　１　全て窓口支払"]
[null,null,null,null,"　２　全て事業所請求（本申込書に記載のない検査を追加した場合も事業所請求）"]
[null,null,null,null,"　 3　基本健診・一般健診 は事業所請求"]
[null,null,null,null,"　 4　基本健診・協会けんぽ補助（一般健診・節目健診・子宮がん検診・乳がん検診・骨密度検診）\n　　  のみ事業所請求、その他は窓口支払"]
[null,null,null,null,"　 5　その他　（具体的にご記入ください）"]
[null,null,null,null,"例１)「基本健診」「一般健診」「胃カメラ変更料金」は事業所請求。その他のオプション料金は窓口支払。"]
[null,null,null,null,"例２)申込書に記載しているコース・オプション料金は全て事業所請求。その他のオプション料金は窓口支払。"]
["▼郵送物の送付先"]
["事前送付物\n(受診票・検査キット)",null,null,null,"　1  事業所へ\n ",null,null,null,null,null,"2  受診者自宅へ\n （住所情報もお送りください）",null,null,null,null,null,null,null,"３ その他\n ",null,null,"（〒    　　   -    　　   　）"]
[]
["個人結果",null,null,null,"　1  事業所へ\n ",null,null,null,null,null,"2  受診者自宅へ\n",null,null,null,null,null,null,null,"３ その他\n ",null,null,"（〒    　　   -    　　   　）"]
[]
["請求書\nおよび\n事業所用控え",null,null,null,"　1  事業所へ\n ",null,null,null,null,null,null,null,null,null,null,null,null,null,"２ その他\n ",null,null,"（〒    861  -    4173 　）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"熊本県熊本市南区御幸木部1-1-1  医療法人桜十字 桜十字病院"]
[null,null,null,null,"請求書は通常、月末締め・翌月20日前後の発送です。事業所用控えは法定項目のみ※1を発行します。\n法定項目以外の結果を新たに記載する場合は契約書の取り交わしが必要ですのでお申し出ください※2。\nなお、全て窓口支払の場合は事業所用控えは発行いたしません。"]
[]
[]
["※１　法定項目とは、労働安全衛生規則第44条等に明記された健診項目です。"]
[]
["※２　法定項目以外も事業所様控え用結果票に通知する場合は貴社にて全受診者様から同意を得ていただくことが、厚生労働省「事業場における労働者の"]
["    健康情報等の取扱規程を策定するための手引き」に明記されています。"]
[]
[]
["【お申込み方法】メールでのお申込みのみになります。"]
[null,"『企業情報シート』と『受診者名簿』に必要事項をご入力の上、Excelデータをメールにてお送りください。\n【申込書送付先】　Mail：kenshin@sakurajyuji.jp\n※申込書送付後、2週間経っても連絡がない場合はおそれいりますが、お電話にてお問い合わせください。"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"〒860-0833 熊本県熊本市中央区平成3-23-30 サンリブシティくまなん3階"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX：096-378-1213／電話：0570-550-182 （受付時間：平日9:00～16:30 ）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"メール：kenshin@sakurajyuji.jp"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"※ご記入に際し、ご不明な点などはお気軽にお問い合わせください。"]

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["事業所名称",null,null,null,null,null,null,"　受診者名簿【協会けんぽ(人間ドック)専用】"]
[]
[null,null,null,null,null,null,null,null,null,"※保険者番号と保険証記号が必ず同一の企業ごとにお申込ください。\n※10名以上記入する場合はシートをコピーしてください。\n※事前送付物を受診者自宅へ送る場合は、個人住所のわかるものを別途添付してください（様式不問）"]
[null,"第１希望\n予約日\n(西暦)\n例）20260401\n例）2026/04/01\n（曜日は自動で入力されます）"," 漢字氏名\n※姓と名の間にスペースを\n入れてください","ｶﾅ氏名(半角)\n※姓と名の間にスペースを\n入れてください","性別\n\n1:男\n2:女","生年月日\n(西暦)\n例）19900123\n例）1990/01/23\n※スラッシュを入れてください。","保険者番号","保険証記号","年度末\n年齢\n(自動入力されます)","\n電話番号\n（ハイフンあり）\n","保険証\n番号","本人/\n家族\n\n1:本人\n2:家族","基本ドックコース",null,null,"ドック専用オプション",null,null,null,null,null,null,null,null,null,"オプション",null,null,null,null,"オプション検査\n協会けんぽの補助を利用\nしないコースもこちらへ"]
[null,null,null,null,null,null,null,null,null,null,null,null,"胃部X線","胃カメラ",null,"脳\nドック","心臓・\n血管ドック","肺\nドック","メンズ\nドック","レディー\nスドック","膵臓\nドック","基本ドックコース胃カメラのみ",null,null,null,"オプション"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"・鎮静剤\nなし\n・細いカメラ使用","鎮静剤\nあり",null,null,null,null,null,null,"消化器\nドック","フル\nコース\nドック","プレミアム\nドック",null,"40歳\n以上\n偶数","20歳\n以上\n偶数",null,null,"40,45,\n50,55,\n60,65,\n70歳"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"鼻から","口から",null,null,null,null,null,null,null,null,null,null,"オプション"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"通院","宿泊","乳がん\n（マンモ）","子宮がん","骨密度","喀痰","節目健診"]
[1,null,null,null,null,null,"1966/8/5",null,{"$f":"IF(F9=\"\",\"\",DATEDIF(F9,DATE(2027,4,1),\"Y\"))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"○"]
[2,null,null,null,null,null,null,null,""]
[3,null,null,null,null,null,null,null,""]
[4,null,null,null,null,null,null,null,""]
[5,null,null,null,null,null,null,null,""]
[6,null,null,null,null,null,null,null,""]
[7,null,null,null,null,null,null,null,""]
[8,null,null,null,null,null,null,null,""]
[9,null,null,null,null,null,null,null,""]
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["事業所名称",null,null,null,null,null,null,"　受診者名簿【協会けんぽ(人間ドック)専用】"]
["医療法人桜十字　メディメッセ桜十字クリニック"]
[null,null,null,null,null,null,null,null,null,"※保険者番号と保険証記号が必ず同一の企業ごとにお申込ください。\n事前送付物を受診者自宅へ送る場合は、個人住所のわかるものを別途添付してください（様式不問）"]
[null,"第１希望\n予約日\n(西暦)\n例）20260401\n例）2026/4/1\n（曜日は自動で入力されます）"," 漢字氏名\n※姓と名の間にスペースを\n入れてください","ｶﾅ氏名(半角)\n※姓と名の間にスペースを\n入れてください","性別\n\n1:男\n2:女","生年月日\n(西暦)\n例）1990/1/23","保険者番号","保険証記号","年度末\n年齢\n(自動入力されます)","\n電話番号\n（ハイフンあり）\n","保険証\n番号","本人/\n家族\n\n1:本人\n2:家族","受診コース",null,null,"基本ドックコース",null,null,"ドック専用オプション",null,null,null,null,null,null,null,null,null,"オプション",null,null,null,null,"オプション検査\n協会けんぽの補助を利用\nしないコースもこちらへ"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"胃部X線","胃カメラ",null,"脳\nドック","心臓・\n血管ドック","肺\nドック","メンズ\nドック","レディー\nスドック","膵臓\nドック","基本ドックコース胃カメラのみ",null,null,null,"オプション"]
[null,null,null,null,null,null,null,null,null,null,null,null,"34歳\n以下","35歳\n以上","人間ドック",null,"・鎮静剤\nなし\n・細いカメラ使用","鎮静剤\nあり",null,null,null,null,null,null,"消化器\nドック","フル\nコース\nドック","プレミアム\nドック",null,"40歳\n以上\n偶数","20歳\n以上\n偶数",null,null,"40,45,\n50,55,\n60,65,\n70歳"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鼻から","口から",null,null,null,null,null,null,null,null,null,null,"オプション"]
[null,null,null,null,null,null,null,null,null,null,null,null,"基本健診","一般健診",null,null,null,null,null,null,null,null,null,null,null,null,"通院","宿泊","乳がん\n（マンモ）","子宮がん","骨密度","喀痰","節目健診"]
[1,"2026-04-01","桜　十字子","ｻｸﾗ ｼﾞｭｳｼﾞｺ",2,"1990-01-05",null,null,{"$f":"IF(F9=\"\",\"\",DATEDIF(F9,DATE(2027,4,1),\"Y\"))","v":37},"080-XXXX-XXXX",999,1,null,null,null,"○",null,null,null,null,null,null,"○",null,null,null,null,null,null,null,"○",null,null,"室内セット"]
[2,null,null,null,null,null,null,null,{"$f":"IF(F10=\"\",\"\",DATEDIF(F10,DATE(2027,4,1),\"Y\"))","v":""}]
[3,null,null,null,null,null,null,null,{"$f":"IF(F11=\"\",\"\",DATEDIF(F11,DATE(2027,4,1),\"Y\"))","v":""}]

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["事業所名称",null,null,null,null,null,"　受診者名簿【協会けんぽ(定期健診)専用】"]
[]
[null,null,null,null,null,null,null,"※保険者番号と保険証記号が必ず同一の企業ごとにお申込ください。\n※10名以上記入する場合はシートをコピーしてください。\n事前送付物を受診者自宅へ送る場合は、個人住所のわかるものを別途添付してください（様式不問）\n\n\n　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　※プルダウンにて選択してください。"]
[null,"第１希望\n予約日\n(西暦)\n例）2026/4/7","第2希望\n予約日\n(西暦)\n例）2026/4/14"," 漢字氏名\n※姓と名の間にスペースを\n入れてください","ｶﾅ氏名\n※姓と名の間にスペースを\n入れてください","性別\n\n1:男\n2:女","生年月日\n(西暦)\n例）19900123\n例）1990/01/23\n※スラッシュを入れてください。","電話番号\n（ハイフンあり）\n","保険証\n番号","本人/\n家族\n\n1:本人\n2:家族","年度末\n年齢\n(自動入力されます)","受診コース",null,null,null,null,"胃カメラ検査へ変更",null,"協会けんぽ補助利用",null,null,"オプション検査\n協会けんぽの補助を利用\nしないコースもこちらへ"]
[null,null,null,null,null,null,null,null,null,null,null,"34歳\n以下","35歳\n以上","40,45,\n50,55,\n60,65,\n70歳","特定業務従事者健診","　新規雇用健診　","・鎮静剤なし\n・細いカメラ\n使用","鎮静剤\nあり","40歳\n以上\n偶数","20歳\n以上\n偶数","40歳\n以上\n偶数"]
[null,null,null,null,null,null,null,null,null,null,null,"基本健診\n※若年層健診","一般健診","節目健診",null,null,"鼻から","口から","乳がん\n（マンモ）","子宮がん","骨密度"]
[]
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[7,null,null,null,null,null,null,null,null,null,""]
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["事業所名称",null,null,null,null,null,"　受診者名簿【協会けんぽ(定期健診)専用】"]
[]
[null,null,null,null,null,null,null,null,null,"※保険者番号と保険証記号が必ず同一の企業ごとにお申込ください。\n事前送付物を受診者自宅へ送る場合は、個人住所のわかるものを別途添付してください（様式不問）"]
[null,"第１希望\n予約日\n(西暦)\n例）2026/4/7","第2希望\n予約日\n(西暦)\n例）2026/4/14"," 漢字氏名\n※姓と名の間にスペースを\n入れてください","ｶﾅ氏名\n※姓と名の間にスペースを\n入れてください","性別\n\n1:男\n2:女","生年月日\n(西暦)\n例）1990/1/23","保険者番号","保険証記号","電話番号\n（ハイフンあり）\n","保険証\n番号","本人/\n家族\n\n1:本人\n2:家族","年度末\n年齢\n(自動入力されます)","受診コース",null,null,null,null,"胃カメラ検査へ変更",null,"協会けんぽ補助利用",null,null,"オプション検査\n協会けんぽの補助を利用\nしないコースもこちらへ"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"34歳\n以下","35歳\n以上","40,45,\n50,55,\n60,65,\n70歳","特定業務従事者健診","　新規雇用健診　","・鎮静剤なし\n・細いカメラ\n使用","鎮静剤\nあり","40歳\n以上\n偶数","20歳\n以上\n偶数","40歳\n以上\n偶数"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"基本健診\n※若年層健診","一般健診","節目健診",null,null,"鼻から","口から","乳がん\n（マンモ）","子宮がん","骨密度"]
[]
[]
[1,"2026-04-07","2026-04-14","桜 十字子","ｻｸﾗ ｼﾞｭｳｼﾞｺ",2,"1990-01-05",null,null,"080-××××-××××",999,1,{"$f":"IF(OR(F9=\"\",G9=\"\",L9=\"\"),\"\",DATEDIF(G9,DATE(2027,4,1),\"Y\"))","v":37},null,"○",null,null,null,null,null,null,null,null,"室内セット"]
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