Registration form

* indicates a required field

Please read the IHCH Code of Conduct before you proceed

IMPORTANT MESSAGE:

Due to the high number of new registrations with our GP section, the waiting times for consultations  with our GPs are longer than we consider acceptable for our existing clients.  Therefore, we are putting a temporary stop to new registrations until the waiting times are back in line with our quality standards. 

Registrations for our polyclinic, dentistry and pharmacy will be continued.

You can leave your email address if you would like to be informed when the patient stop has ended.

If you have an acute medical problem you can go to MCH hospital, huisartsenpost,

AddressLijnbaan 32, 2512 VA Den Haag, or try to find a family practice near  you

 

Your primary residence (home address)

Other family members registering

Family member #1
Family member #2
Family member #3
Family member #4
Family member #5

Registration & appointment

Register with GP/Huisarts
Booked appointment
Will you be bringing a referral letter with you?
(Necessary if you have an appointment with a specialist, are registered with a GP elsewhere and have Dutch insurance)
Please upload your referral letter, if any (as a scan, PDF or good photo with your phone).
Please indicate here if you are changing insurance provider, address, have a special request or would like to leave a comment.

By submitting this form, I/we understand and agree to the terms and conditions on the IHCH website and in the IHCH Code of Conduct. I/we also agree to be a registered patient(s) at the IHCH located at Jan van Nassaustraat 125, 2596BS The Hague



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