First appointment

To make a first appointment you can also complete this form as completely as possible. One of the assistants will contact you as soon as possible.

Name*

Zip code*

House number*

Phone number*

Email*

BSN*

Birthdate*

1st day of menstruation*

Have you been controlled by us earlier?*
yesno

Comments

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Spoed / Emergency

EMERGENCY?

Call our emergency number:

010-455 97 09

Address

Verloskundigen Rotterdam West
Heemraadssingel 152
3021 DK Rotterdam

Tel nr: 010-456.83.69

P.C. Hooftplein 45
3027 AW Rotterdam

Only if no answer:
Doctors Line: 0251-260.224