Menu sluiten
Individual
Employer
Business Portal
My HollandZorg
Search
English
English
Nederlands (Nederland)
Home
Healthcare insurance
Public healthcare
Compulsory excess
Personal contribution
Supplementary insurance
Dental insurance
Healthinsurance via Employer (Flexpolis)
Healthcare allowance
Reimbursements 2022
Urgent foreign care
Physiotherapy and remedial therapy 18+
General practitioner care
Maternity care
Orthodontia (braces)
Dental care aged 18 and older
Healthcare country of residence
Medical care in the Netherlands
S1/E106 form
Family members
Reimbursement in country of residence
Healthcare covered in country of residence
Service and contact
Rate list 2022
Rate list 2021
Reimbursements 2021
Claim expenses
Cancellation of health insurance
Lodging a complaint
Forms
Documents
Care guide
Conditions and regulations 2022
Conditions and regulations 2021
Frequently asked questions
Care Service
Hollandzorg App
Home
>
Apply Healthcare mediation
>
Apply mediation
At HollandZorg, you can simply apply for healthcare mediation online. Please complete the healthcare mediation application form. One of our members of staff will contact you within two working days to discuss your options.
Fill in the following form
Gender*
Madam
Sir
Initials*
Inserts
Surname*
Postal code*
House number*
Addition
Street name*
City/town*
Date of birth*
Phone number*
Email adress*
Waiting list mediation
How can we help you? (Attention: We advise you not to share any medical information or BSN with us through this form)
Name care provider/care institution
Location care provider/care institution
In case of hospital care: specialism
What is the current waiting time?
Have you had a first call yet?
Yes
No
