Registration Form

    Personal data

  • Address info

  • You CAN register if you already live or will shortly move to postcode area: 1055, 1014 and 1056-between our practice and Jan van Galenstraat. You can NOT register if you already are registered with a GP-familydoctorspractice in one of these postcode area's
  • Insurance info

  • Previous GP/pharmacy

  • Your attention: please inform your previous GP that you have registered with us and give the GP permission to send us your file