How to apply

Applications go through your GP. Do you already have a valid referral letter? Then you can apply directly using the form on this page. Below you can see exactly what is asked of you and what happens next.

01
Go to your GP
Tell them what is going on and ask for a referral to SENTIS Psychologen. Your GP sends it to us through Zorgdomein, the Dutch referral system.
02
We read your referral
We look at whether your request fits our practice and fits basic mental healthcare. Sometimes we ask your GP for additional information.
03
You hear from us by email
If it is a good fit, we email you to ask about your availability and schedule the intake. If it is not a fit, we will let you know by email as well, and explain why.

Application form

Everything marked with an asterisk is required. The rest helps us assess your application faster.

Your details

Initials Capital letters only, no dots or spaces

First name

Name prefix

Last name

Gender

Date of birth

Phone

Mobile

Your address

Street

House number

Addition

Postcode

Town

Insurance and BSN

Citizen service number (BSN) Needed to claim your treatment with your health insurer

Health insurer

Policy number

Your GP and referral

GP name

GP practice

GP AGB codeIt is on the referral letter. If you do not know it, leave it empty.

Do you have a referral letter?

Upload referral letter

Choose fileNo file chosen yet

Optional — pdf or photo, up to 8 MB

Additional information

In which language would you like to be treated? Our therapists work in both languages.

Anything else you want to tell us?

We reply within ten working days.

Your details go straight into our client system Praktijkdata and are not stored on this website.

How to apply

Go to your GP

We read your referral

You hear from us by email

Application form

Thank you — your application has arrived

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