Get Hollandzorg

Filling out the Hollandzorg registration form online is a straightforward process. This guide provides detailed, step-by-step instructions to ensure that you complete each section accurately and efficiently.

Follow the steps to fill out the Hollandzorg registration form online.

1. Click ‘Get Form’ button to obtain the Hollandzorg registration form. This will enable you to access the necessary document.
2. Begin filling out the applicant section by entering your initials, full name, date of birth, telephone number, and email address. Select your marital status and nationality. If you do not hold Dutch nationality, include relevant documentation to prove your entitlement to Dutch health insurance.
3. In the address details section, provide your current residential address, including street, postal code, house number, city, and country. If you do not reside in the Netherlands, include your foreign address.
4. If applicable, fill in the employer section. Provide the employer's name, address details, and state the date you started working. If you work in the Netherlands, ensure to upload a copy of your employment contract and your latest payslip.
5. Indicate whether the policyholder must be insured. If yes, proceed to the insurance section, where you will select your desired options for basic insurance, voluntary excess, and supplementary insurance, including dental insurance.
6. List any additional persons to be insured. For each person, enter initials, full name, date of birth, and nationality. Select the appropriate insurance options for each additional insured person.
7. In the payment section, choose your preferred payment method: direct debit or giro collection. Fill in the required banking information for the direct debit option.
8. Review the declaration/signature section. Understand the terms stated and sign the form, confirming that all information is correct and complete.
9. Once you have filled out all sections of the form, make sure to save your changes. You may then download, print, or share the form as needed.

Complete your Hollandzorg registration form online today for a seamless health insurance experience.