Registration 2016-11-10T20:28:16+02:00

THE JOURNEY OF DISCOVERY

Register online now! Verloskundigen Amsterdam Zuid

Registration

Are you pregnant and would you like to meet us? Then register online now! You can do so as soon as you have had a positive pregnancy test.

Register online now!

First name*
Surname*
Initials*
Date of birth*
Burger Service Nummer - BSN*
Address*
ZIP code/Postcode*
City*
Telephone number*
E-mail address*
General practitionar*
Insurance company*
Marital status*
Name of partner
Children*
Pregnancy*
First day of last menstruation*
Have you been a client before*
Questions or remarks