Register at our practice

We welcome new patients.

Are you searching for a new general practicioner and residing in our postal code area? By sending in the 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 practicioner. You will have to inform your current general practicioner of leaving yourself.


Our 'postal code area'

Our patients live in the neighborhood of Kerkelanden or in surrounding neighborhoods that can be reached by car within 15 minutes.
This allows us to provide emergency care at home, without the travel distance causing too long a delay.

Registration form

Page 1 of 5

Only patients from the postal code areas 1213121412151216 and 1231 can register directly at our practice. If you live outside these areas, we ask you to contact us first by telephone.

Title
Personalia
Country of birth