From application to patient

Thank you for your interest in our practice!

We are no longer scheduling intakes this year. However, you can fill out the online application form (see below).

We will take your application and schedule an intake appointment in 2025.

Would you be kind enough to send us your old dental records prior to the first appointment?

Once you have come to us for an intake and get along with the practitioner, you are officially registered as a patient with us.

If you have severe pain symptoms before then, please contact either:

• your previous dentist,
• or, the Mondzorgpoli in Slotervaart hospital https://www.mondzorgpoli.nl 020 723 4848
• This clinic can normally see you the same day.

Please complete the questionnaire below:

-> Intake form child

-> Intake adult (16 years and older)

NOTE: when we receive your information (application form and/or old file), but you do not schedule an intake appointment within 6 months, we deactivate your patient card.