We welcome new patients.

Are you searching for a new general practitioner and residing in our postal code area? By sending in this registration form you can register directly at our practice.
By using this form you give us your consent to withdraw your registration from your current general practitioner. You will have to inform your current general practitioner of leaving yourself.

Of course you are also welcome to become acquainted with us at our practice first. For this please contact the assistant.

---

Postal code area and 'patient stop'

In the Netherlands we have a free choice of physician which means that you can choose a general practitioner yourself.

In practice, however, you may not be able to register at the general practitioner of your choice. For example because you live too far away from that general practitioner or because that general practitioner has no room for new patients.

• In our practice we only register patients who reside in the postal code area of .....
• Currently general practitioner .................... has a temporary patient stop.