Registration form

Clients can only register for treatment by completing the registration form below. Referrers can fill in the registration form together with their client.

Merith Cohen de Lara doesn’t take new clients. The waiting list for a contracted psychologist is 3/4 weeks. The waiting list for a contract-free psychologist is 8 weeks. For an online treatment (psychologist Eva van Ormondt) the waiting list is 2 weeks. There is no waiting list for an online or a group treatment.

Before you start your treatment, check with your insurer how much is reimbursed and if you need a contracted psychologist. Contract-free psychologists ( often have no or a much shorter waiting list. At least half of the basic mental health care is generally reimbursed, regardless of what policy you have. Read more about rates and Insurers.

After processing your application, you will be contacted by telephone or e-mail. For urgent questions, please send an email to

Please use this form to register with one of our therapists. Fill in the form as completely as possible. The fields marked with an asterisk are obligatory.
  • Choose your therapist from the list. If you have no preference choose 'Secretary'. You will then be assigned to the first available therapist.
  • This field is for validation purposes and should be left unchanged.