Registering new patients

We are happy to welcome new patients, but only if you are still no GP in Amstelveen and lives in postal code area 1181 or if you are a student and live at Uilenstede.

Do you fall within this target group? Then you are welcome to register with us. This can easily be done via the registration form below. As soon as we have received your registration, we will contact you by telephone.

Are you visiting us for the first time? Then always take your insurance card and a valid identity document (passport or identity card) with it.

Registration form for new patients

Surname(Required)

Maiden name

Initials(Required)

Call sign(Required)

Date of birth(Required)

Gender(Required)

Man

Woman

Marital status(Required)

Address details

Street name(Required)

House number(Required)

Postcode(Required)

Residence(Required)

Email address(Required)

Phone number(Required)

Previous GP details

Name of previous GP(Required)

Address and city(Required)

Phone number(Required)

Today's date(Required)

Current pharmacy details

Pharmacy name(Required)

Pharmacy address(Required)

Pharmacy phone number(Required)

We work closely with Randwijck Pharmacy. Would you like to adopt this pharmacy as your new pharmacy?(Required)

Privacy

Contact

	+31(0)20 643 01 30
	Hoeksewaard 147 A 1181CD Amstelveen

Opening hours

Monday	08:00 - 17:00
Tuesday	08:00 - 17:00
Wednesday	08:00 - 17:00
Thursday	08:00 - 17:00
Friday	08:00 - 17:00
Saturday	Closed
Sunday	Closed

Practice information

Reliable information

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