Register

Complete the form below to register with Jans Huisartsen.

At the moment, the Rotterdam Centrum practice is temporarily closed for new patients. However, you can register at Kralingen or Zuidplein.

Name*
First Name Last Name
Gender*
Date of birth*
Day
Month
Year
Address*
Email address*
Phone*
Location*
Agree enrollment and request file*
- I agree to enroll with Jans Huisartsen and also give permission to request my records from my previous health care provider.
Data processing agreement*
- I agree to Jans Huisartsen processing my data required for enrollment.
Agreement LSP
- I give permission to Jans General Practitioners for access to my complete medical file via the LSP and for making my medical data available to other healthcare providers when necessary, as indicated via the LSP. I declare that I am aware of the information from the online brochure about LSP permission (www.volgjezorg.nl/toestemming). As indicated through the National Switch Point (LSP). I certify that I am aware of the information in the online handout on LSP consent (www.volgjezorg.nl/toestemming)

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