Registering with our general practice

Thank you for wanting to register with our practice! Please complete the registration form below to start your application. At present, we are only accepting new patients who live within 3.5 kilometres of our practice. If you live outside this area, we are unfortunately unable to register you.

Please note: your registration is not yet final. After you have completed the form, we will contact you by telephone to complete the registration together.

• On your first visit, we ask you to bring your insurance card and valid proof of identity (Dutch or foreign passport or ID card).
• Would you like to register your child(ren) as well? Please complete a separate registration form for each child. On your first visit, please bring your child's insurance card and valid proof of identity.