Online registration form

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

Personal details

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?

Former GP

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


Complete registration

We kindly request to print the completed form. You can hand in the form at the counter of the health center. You do not have to make an appointment for this.

You can find the opening times on the website of the health center. Please note that it is very busy in our health centers before 10 a.m. You might have to wait a while until we can help you.

Please don’t forget to bring your insurance certificate and proof of identity to the health center. After we have received the registration form and have seen your proof of identity and insurance, you are registered.