General questions

In order to determine whether you can use this form, a number of general questions follow. Please answer these questions truthfully.

Filling out the registration form only makes sense if you have received permission from the practice to register.
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Our catchment area

In case of emergency, the doctor should be able to visit a patient within 15 minutes. In order to meet this legal requirement, our catchment area consists of the zip code areas 3078 and 3079 and a limited part of 3077 and Barendrecht.

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Filling out the registration form only makes sense if you have received permission from the practice to register.
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You can register at Odedokter's GP practice

You have indicated that you live in our catchment area and that you do not have a doctor in this area.
To register at Odedokter General Practice, you must arrange the following:
  • Tell the doctor where you are currently registered that you are switching to us.
  • Make sure you have a DigiD with text message or the DigiD app.
  • Complete this registration form and press submit.
Once we have received your registration form, we will get to work:
  • We request your medical file from your previous doctor.
  • We'll create an account for you at www.myhealth.net.
  • As soon as we have your medical file, we will send you an email.
You take the last step. Our message contains a link to your account:
  • You log in with Digid at www.myhealth.net and then you are
    registered with Odedokter.

The registration form

You can now start filling out the registration form.
You will go through the following steps:
  • Personal, address and contact details
  • Insurance details, BSN, ID
  • Details of previous doctor and pharmacy
  • Medical data
- Drug use and allergies
- Chronic diseases
- Major disorders
- Lifestyle and prevention
  • Consent to request and share data
In our experience, medical records are often incomplete, which is why medical information is also requested on this registration form.
Privacy regulations
We process medical data about our patients. Due to the sensitivity of this data, we attach great importance to privacy. In our privacy regulations you can read what personal data we process and what for. It also states in the privacy regulations included what rights you have.

Personal Data

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Address details

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CONTACT DETAILS

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Legal representative (s)

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Insurance details, social security number, ID certificate

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Previous GP details

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Current pharmacy details

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Current pharmacy details

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NEW PHARMACY?

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Medical data

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Do you have a chronic illness or does it run in your family?

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LIFESTYLE

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Prevention

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Consent to request data

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Consent to exchange data

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Permission to exchange data with the GP office and service pharmacy via the National Exchange Point

Good, safe and fast care - we all want that when we need it. Whether we are chronically ill or come to the GP office after an accident. All of this starts with information about our health.

The general practice can share important information about your health with other healthcare providers via the National Switching Point. We will only do this if you are okay with it.

Click Follow your care and always read the information folder: follow your care to make a choice.
  • For children up to 12 years old: you consent as a parent or guardian.
  • For children aged 12 to 16: both you as a parent or guardian and the child give permission.
  • Children from the age of 16 give their own consent.
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  • Tell a doctor's office employee.
  • Arrange it online Personal environment: follow your care.

Privacy regulations

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Registration form

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