Head of the family

Salutation: Mr.Mrs. First name Initials Insertion Last name Date of birth Social security number

Address

Address Postal code + town / City Telephone number Mobile phone number E-mailaddress

Partner

Add partner YesNo

Children

Add children YesNo

Some questions

Who brought you to us? Why did you choose our practice?

Conditions

I have read and agree to the general terms and conditions of Beekmans Tandartsen, including the cancellation and protection of personal data below:
Cancellation terms and conditions Appointments that are rescheduled or cancelled by the patient for whatever reason must be communicated to us at least 48 hours in advance during office hours, preferably by telephone. If you do not notify us in time, we will charge you for the cost of the lost time.
Protection of personal data I allow my personal data, images, results and/or models to be shared with third parties. These are colleagues, dental technicians, health insurers and government agencies. My data may also be used anonymously for research, publications, accreditations, lectures, own website and patient information.

Registration

Not yet a patient with us?
Welcome to Beekmans Tandartsen. Our goal is to give you healthy teeth for the rest of your life! How do we do this? We differentiate ourselves by the use of high-tech equipment and the very best training for the team.
Through our professional skill and advanced equipment, we can make a very comprehensive and in-depth analysis of your dental condition.
In our practice we use Zeiss microscopes, every tiny detail comes to the surface, so we don’t miss anything that could get your teeth in trouble. We use all this data to create a long-term total solution for you.
Feel free to contact us by phone, or drop by and see if you feel comfortable with us.
Would you like to register? Please click here. (online registration form)
Beekmans Tandartsen