Book online | Fysiotherapie Bezuidenhout Den Haag

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Easily make an appointment online with one of our therapists using the form below.

If you make an appointment with us for the first time, we need one-off additional details from you, such as address details and your social security number.

Is this your first visit at Fysio Bezuidenhout?

Yes

Personal data

Mr.

Mrs.

First name*

Suffix

Last name*

Date of birth*

Citizen service number*

Contact data

Phone number*

Email*

Address

Postcode*

Street number*

Street*

City*

Date and time

Please enter at least one preferred date and time.

1st preferred date + time*

2nd preferred date + time

3rd preferred date + time

Appointment data

Do you want to be treated by a specific therapist? Then indicate your preference below.

Brief description of your complaint*

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Quick and easy

Is this your first visit at Fysio Bezuidenhout?

Personal data

Contact data

Address

Date and time

Appointment data

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