Register at our practice

You want to register with our practice. We wish you a warm welcome!

You can register with us if you live close to the practice in one of the following zip code areas: 1072/1073/1074/1078/1079/1091.
We only deviate from this in exceptional cases. This applies, for example, to a part of zip code area 1096 and 1097. If this applies to you, please contact our assistant.

By using our registration form you can register directly. In case your address at the insurance company is different from your residential address, please indicate this at the comment field

You also have to inform your current general practitioner of your leaving and send us your medical file.

 

Registration form

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Title
Personalia
Burgelijke staat
Country of birth