Registration form English

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Registration form
Huisartsenpraktijk de Getijdenmolen
Stadsschuur 1, Middelburg 4331KS
0118 628234


Personal data
Address data
Insurance details, citizen service number and pharmacy
Details of previous GP
Medical data
The patient's consent for requesting and exchanging data with other healthcare providers, with due observance of medical professional secrecy.
Requesting your medical records from your previous GP is necessary to provide medical care.
You can call after 4 weeks to see if your file is in, so we can have an introductory meeting. For this, you must identify yourself to the assistant for the first time with an official document (passport, driving license, etc...). This is required by the ID Act.
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