Online registration form

Select your health center below or select a center on the map

Personal details


Do you have a CSN number?

Insurance details

Permission questions


Do you give us permission to use your mobile phone number for our sms service?



Do you give us permission to use your email address for our email service?



Do you give the health center permission for making your medical information available through the LSP with other caregivers?



Online patient portal

Our health center has an online patient portal. Via this portal you can make appointments, request repeat prescriptions and conduct an eConsult with your doctor. Do you want to use this service? Then take the following steps:

  1. create a new account in our patient portal
  2. click within 24 hours on the confirmation link in the e-mail you receive
  3. your account details will be compared to the details already known to us. In case of uncertainties we will contact you to complete the registration
  4. after completion we will activate your account and you will be able to use our online services.

Former GP


Do you give us permission to obtain your medical file from your former GP?


Other


Complete registration