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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?



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. show your proof of identity in our health center so we can be sure that you are the one who gets access to your account.

After identification in our health center we will activate your account and you can use the online services.

Former GP


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


Other


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.