Registering


You are very welcome at the Hollands Spoor dental practice.

Please fill out the registration form below.

Once we have received your personal information, we will contact you to make an initial consultation and introductory meeting.


Preference for a dentist
No preference
Dentist Paula Grewe
Dentist Willem Lely
Dentist Derk Kösters



Initials


Mr. Ms. *


 
 





 
 





 
 





 
 


 
  I agree with the Privacy Statement
Form can only be sent if checked!


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First appointment


Please bring your ID when you come to our practice. You will also need to fill out a one-time medical questionnaire. If you are taking any medication, would you please list the name and dosage?


Recent X-rays are necessary to get a good impression of your teeth. If these X-rays are older than two years, of poor quality or missing, they will be redone. In some cases it is necessary to make an additional X-ray of a specific area. You will be informed in advance if this is the case. After the initial consultation, you will have become a patient in our practice.



Dental Practice Hollands Spoor
Stationsweg 107 1st floor
2515BL the Hague

Dentist P. Grewe
(070) 3800910
Dentist C.W. Lely
(070) 3803100
Dentist D.R. Kösters
(070) 3802891

info@tandartsenpraktijk-denhaag.nl



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