You may answer the questions below so that we can create your patient card. After we have received your information, we will contact you by telephone to make an appointment. We are obliged to check your ID prior to the first appointment and we, therefore, request that you bring a passport, European ID, or driver's license. It is also necessary to complete a health questionnaire. These administrative actions take approximately 5 minutes and we, therefore, appreciate it if you come to the practice 5 minutes before your first appointment.
If you are going to change the dentist, we also request that your file be sent by your previous dentist to firstname.lastname@example.org.
Fields with a * must be filled in mandatory and truthfully.
Your personal data will be treated according to the General Data Protection Regulation (GDPR).