This service is only possible if you have been to our consultation hours in the last 8 weeks! Otherwise, please make an appointment!

Please note the corresponding pick-up times!

Monday till Friday: 11:00–12:00 PM
Tuesday, Thursday: 3:00–5:00 PM

    Have you seen the doctor in the last 8 weeks?

    If not, we kindly ask you to make an appointment here.

    Upload image if desired

    Your form will be ready for pickup in 1 week.