Registration form

Due to the large number of registrations, we are forced to work with a waiting list – completely against our objective. At the moment we consider our waiting list to be irresponsibly long (at least 6 weeks) and we cannot offer the help that we would like. We are currently discussing this with various authorities. We therefore ask you to contact your doctor to see if there are other ways to receive help.

There is no waiting list for treatments via Skype.

Registration form

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 then choose 'secretary' who will then contact you.
  • Dit veld is bedoeld voor validatiedoeleinden en moet niet worden gewijzigd.