Postcode gebied Veelgestelde vragen
0342 231 900 [email protected]

Permission form

Permission form

To send your medical file, we need your permission.

Please click the link below to open the form. After filling in the form, it can be emailed to [email protected]. If this does not work, you can also send it by post or deliver it at the desk.

Without this form your medical file cannot be sent to your new GP.