Make an appointment

Make an appointment

In order to schedule a first appointment and/or put you on our waiting list, we need a referral letter from your General Practitioner.
Please make sure that you have your referral letter available for upload before you fill out the application form. Without the referral letter you will not be able to submit your application.

    As soon as we have received your application form we will do our very best to contact you within one working day.
    In case you experience problems whilst completing this form, or if you have any questions about applying, please send an email to info@inter-being.nl.

    Please upload you referral letter

    Do you have a Dutch BSN number?

    What health insurance will you be using?

    If you selected 'Dutch Health insurance', please specify the name of the company underneath:

    If you selected AON, do you also have a Dutch Health insurance:

    YesNo

    If you selected European Health Insurance Card, do you also have a Dutch Health insurance:

    YesNo

    If you selected 'Other', please specify the name of the company underneath:

    In which city are you looking for therapy?

    Preferred language(s) for your therapy in Amsterdam:

    Preferred language(s) for your therapy in Groningen:

    Preferred language(s) for your therapy in Delft:

    Preferred language(s) for your therapy online:

    Do you have a preference for a male or female psychologist?

    Would you like to have your therapy online or face-to-face?

    How did you hear about us? (optional)

    If you selecterd 'other, please specify:

    Have you had therapy before?

    Have you ever been hospitalized for a mental health condition?

    Do you currently take medication for a mental health condition?

    Have you had contact with a mental health crisis unit (crisisdienst) during the last 12 months?

    Amsterdam & Groningen

     

    info@inter-being.nl

     

    +31 (0)6 29 44 57 50

     

    Inter-Being

     

    Weteringschans 130-1, 1017 XV, Amsterdam

    Hoge der A 3-B, 9712 AC, Groningen