Registration form
Please read our registration procedure carefully before registering: Registration and contact information
FOR OUR CURRECT WAITING TIME FOR INTAKE AND FOR START OF THE TREATMENT SEE OUR WEBSITE:
Our waiting time and health care insurers
NOTICE: For 2025 we are not contracted with EUcare (Caresq, Aevitae)
Please note: you will receive a confirmation email (right after you registered through below form). If this is not the case then your registration is not succesful. Please try again.
You will only be contacted by us via a call in case there is more information needed to complete the registration.
It is important that you check your e-mail regularly. We may send updates regarding your registration and treatment.
For completeness we would like to point out that content sent to us and from us by email, is not secured. For sending emails and/or documents with privacy-sensitive information we use another secure email platform.
REGISTRATION FORM
Your details will be processed and stored within our own system and our own server and are not accesible by third parties.
Your referral letter should at least contain the following information:
- Your full name and BSN number (social security number)
- Adressed to a Psychology practice
- Name en AGB-registration number of the referrer
- Signature date can not be older than 9 months