Registration form

IMPORTANT INFORMATION
Due to the large number of registrations we are forced to work with a waiting list. At the moment our waiting time is approximately
 3/4 weeks.

Contract-free psychologists have a shorter waiting list. Please check your insurance for what they reimburse for treatment by a contract-free psychologist.

There is no waiting list for online treatments (Skype / Facetime). If you want to this, you can indicate this on the registration form.

Applications are processed three times a week by the secretary. After processing your registration, you will be contacted by telephone or e-mail.

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.