Register as a new patient.

Please complete the form below in full. Once received, the practice will review your registration and you will receive confirmation by email within 72 hours.

New to the Netherlands?

Before you register, read how GP care works in the Netherlands in our leaflets for expats and students: English, Deutsch, العربية.

Personal details

Sex *

Male Female Other / unknown

First name *

Name prefix

Surname *

Date of birth *

Country of birth

BSN (citizen service number)

Optional — you can find it on your ID

Address

Postcode *

House no. *

Addition

Street *

Town/city *

Contact details

Phone number *

Email address *

Current GP

Name of your current GP or practice in the Netherlands

Optional — leave empty if you don't have a GP in the Netherlands

Consent

By registering, you agree to the processing of your personal data in accordance with the GDPR (AVG).

Reading aid

Register as a new patient.

Registration received!