Welcome at Verloskundigenpraktijk Breedstraat

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Congratulations! You are pregnant!

After completing and submitting this form, we will contact you to schedule an appointment. This will usually take place between the 10th and the 12th week of pregnancy. After making your first appointment, you will receive a questionnaire by email. We would appreciate it if you could complete this and return to us. We would also like to ask you to bring proof of health insurance, identity and details of any previous pregnancy (ies) when you attend your first appointment.

Should you have any questions or concerns, please do not hesitate to contact us on: 030 – 23 11 376 Monday to Friday 9.00am – 1.00pm. In case of emergency please ring 06 - 49 777 349 (24/7).


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Phonenumbers / Email address

Marital status

Menstruation


Moeders voor Moeders

Mothers for Mothers here

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