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Registration form

Our surgery is open for new patients. If you live in our neighbourhood, then you are welcome. Please contact our assistant before you fill out the form. Our surgery has many expats as patients. We are familiar with other customs and wishes and speak several languages.

Introductory consultation

We appreciate meeting you very much. It is very important to know your medical history, and for this reason we plan an introductory consultation. During this consultation the doctor will ask you all about your medical history and family medical history. We reserve at least 20 minutes for this consultation, which is charged to your insurance.

Note: we will try to process your registration form within two working days. For large wounds or urgent problems, please call us. 

Registration Citizen service number (BSN)

As a healthcare provider, we have to use your BSN. We are obliged to check that you are the person registered with the BSN. Therefore, we may ask you for valid identification. We are not allowed to make a copy or scan. For this reason, we only register the document number of your identification. For more information see page Registration Citizen service number (BSN).

Choice of GP

As a patient of Huisartsenpraktijk Statenkwartier you are a patient of the surgery. You will not be assigned to a specific doctor. Regarding the choice of a doctor, we apply the policy as described on page Choice of GP.

Deregister from former GP

If you registered with us, then please be so kind to inform your former GP in The Netherlands. We will ask him/her to send us your medical files.

Registration form

To register, you will need to fill in our registration form. The completed form can be returned by email (info@hapstatenkwartier.nl), fax (070-358 41 46), or you can hand it to one of our assistants at the surgery. We will process your registration as soon as possible. We will try and contact you within three working days to plan an introductory consultation.