Inschrijven

${ parent.decodeEntities(`De inschrijving mag ingaan per:`) } * <${props.Flatpickr} name="inschrijfdatum" className="mf-input mf-date-input mf-left-parent " placeholder="${ parent.decodeEntities(``) } " options=${{"minDate":"","maxDate":"","dateFormat":"d-m-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}} value=${parent.getValue('inschrijfdatum')} onInput=${parent.handleDateTime} aria-invalid="${validation.errors['inschrijfdatum'] ? 'true' : 'false'}" onReady=${(dates, dateStr, instance) => props.DateWidget( instance, 'nl', {"message":"Dit veld is verplicht","required":true}, register, parent )} /> <${validation.ErrorMessage} errors=${validation.errors} name="inschrijfdatum" as=${html``} />

${ parent.decodeEntities(`Voorletters`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="voorletters" as=${html``} />

${ parent.decodeEntities(`Roepnaam`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="roepnaam" as=${html``} />

${ parent.decodeEntities(`Achternaam`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="achternaam" as=${html``} />

${ parent.decodeEntities(`Geboortedatum`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="geboortedatum" as=${html``} />

${ parent.decodeEntities(`Adres en postcode`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="adres_postcode" as=${html``} />

${ parent.decodeEntities(`BSN`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="BSN" as=${html``} />

${ parent.decodeEntities(`Telefoonnummer`) } { parent.activateValidation({"message":"Dit veld is vereist.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="telefoonnummer" as=${html``} />

${ parent.decodeEntities(`Mobiel`) } { parent.activateValidation({"message":"Dit veld is vereist.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mobiel" as=${html``} />

${ parent.decodeEntities(`Emailadres`) } * parent.activateValidation({"message":"Dit veld is verplicht","emailMessage":"Vul een geldig e-mailadres in","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} /> <${validation.ErrorMessage} errors=${validation.errors} name="emailadres" as=${html``} />

${ parent.decodeEntities(`Zorgverzekering`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="zorgverzekering" as=${html``} />

${ parent.decodeEntities(`Polisnummer`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="polisnummer" as=${html``} />

${ parent.decodeEntities(`Apotheek`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="apotheek" as=${html``} />

Identiteitscontrole:

${ parent.decodeEntities(`Documenttype`) } * <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-select'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-select" placeholder="${ parent.decodeEntities(`Selecteer uw documenttype`) } " isSearchable=${false} options=${[{"label":"Paspoort","value":"paspoort","isDisabled":false},{"label":"Rijbewijs","value":"rijbewijs","isDisabled":false},{"label":"ID-kaart","value":"ID-kaart","isDisabled":false},{"label":"Vreemdelingendocument","value":"vreemdelingendocument","isDisabled":false},{"label":"Buitenlands paspoort","value":"buitenlands paspoort","isDisabled":false}]} value=${parent.getValue("mf-select") ? [{"label":"Paspoort","value":"paspoort","isDisabled":false},{"label":"Rijbewijs","value":"rijbewijs","isDisabled":false},{"label":"ID-kaart","value":"ID-kaart","isDisabled":false},{"label":"Vreemdelingendocument","value":"vreemdelingendocument","isDisabled":false},{"label":"Buitenlands paspoort","value":"buitenlands paspoort","isDisabled":false}].filter(item => item.value === parent.getValue("mf-select"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-select")} ref=${() => { register("mf-select", parent.activateValidation({"message":"Dit veld is vereist.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-select") === '' && false ) { parent.setValue( 'mf-select', '', true ); parent.handleChange({ target: { name: 'mf-select', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-select" as=${html``} />

${ parent.decodeEntities(`Documentnummer`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="Documentnummer" as=${html``} />

Wij verzoeken u vriendelijk om na uw inschrijving de praktijk te bezoeken en uw identiteitskaart mee te nemen ter controle.

Woonverband:

${ parent.decodeEntities(`Zijn er op dit adres meerdere personen woonachtig?`) } *

parent.handleCheckbox(el, 'onLoad')} className="mf-checkbox multi-option-input-type" id="mf-input-checkbox-7dcb096">

parent.handleCheckbox(el.target, 'onClick') } aria-invalid="${validation.errors['Meerder_personen_woonachtig'] ? 'true' : 'false'}" ref=${el => { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} } /> ${ parent.decodeEntities(`Nee`) }

<${validation.ErrorMessage} errors=${validation.errors} name="Meerder_personen_woonachtig" as=${html``} />

${ parent.decodeEntities(`Worden deze personen ook patiënt bij onze praktijk?`) } *

parent.handleCheckbox(el, 'onLoad')} className="mf-checkbox multi-option-input-type" id="mf-input-checkbox-7cfdeb0">

parent.handleCheckbox(el.target, 'onClick') } aria-invalid="${validation.errors['patienten_ook_patient'] ? 'true' : 'false'}" ref=${el => { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} } /> ${ parent.decodeEntities(`Nee`) }

<${validation.ErrorMessage} errors=${validation.errors} name="patienten_ook_patient" as=${html``} />

Medische anamnese:

${ parent.decodeEntities(`Bent u ergens allergisch voor?`) } *

parent.handleCheckbox(el, 'onLoad')} className="mf-checkbox multi-option-input-type" id="mf-input-checkbox-5c6ebe2">

parent.handleCheckbox(el.target, 'onClick') } aria-invalid="${validation.errors['Alergie'] ? 'true' : 'false'}" ref=${el => { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} } /> ${ parent.decodeEntities(`Nee`) }

<${validation.ErrorMessage} errors=${validation.errors} name="Alergie" as=${html``} />

${ parent.decodeEntities(``) } { parent.activateValidation({"message":"Dit veld is vereist.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="toelichting_allergie" as=${html``} />

${ parent.decodeEntities(`Heeft u een chronische ziekte?`) } *

parent.handleCheckbox(el, 'onLoad')} className="mf-checkbox multi-option-input-type" id="mf-input-checkbox-ac0c8bc">

parent.handleCheckbox(el.target, 'onClick') } aria-invalid="${validation.errors['chronische_ziekte'] ? 'true' : 'false'}" ref=${el => { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} } /> ${ parent.decodeEntities(`Nee`) }

<${validation.ErrorMessage} errors=${validation.errors} name="chronische_ziekte" as=${html``} />

Gegevens vorige huisarts

${ parent.decodeEntities(`Naam vorige huisarts`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="naam_huisarts" as=${html``} />

${ parent.decodeEntities(`Plaats vorige huisarts`) } * { parent.activateValidation({"message":"Dit veld is verplicht","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="plaats" as=${html``} />

${ parent.decodeEntities(``) } <${validation.ErrorMessage} errors=${validation.errors} name="Akkoord_gegevens_delen_vorige_huisarts" as=${html``} />

Gegevens uitwisselen:

In sommige gevallen is het handig , bijvoorbeeld als u gebruik maakt van de huisartsenpost, of opgenomen wordt in een ander ziekenhuis, dat de behandelend arts uw dossier kan inzien. Dit gebeurt via het Landelijk Schakelpunt (LSP). Hiervoor moet u zelf toestemming geven. Voor meer informatie kijk op www.volgjezorg.nl , of kijk op Youtube via landelijk schakelpunt. Er liggen ook folders bij de balie over dit onderwerp.

${ parent.decodeEntities(``) } <${validation.ErrorMessage} errors=${validation.errors} name="Akkoord_gegens_uitwisselen" as=${html``} />

${ parent.decodeEntities(``) } <${validation.ErrorMessage} errors=${validation.errors} name="Geen_akkoord_gegevens_uitwisselen" as=${html``} />

Wij maken gebruik van het patiëntenportaal Uw Zorg Online. Zodra u bent ingeschreven, kunt u hier eenvoudig en veilig een account aanmaken. Via dit portaal kunt u afspraken maken, medicatie herhalen en uw medisch dossier inzien

Inschrijven

Moet ik naar de dokter?

Afspraak maken

Wat kan ik doen? (Thuisarts.nl)

Herhaal recept

Spoed telefoon

Inschrijven

Moet ik naar de dokter?

Afspraak maken

Wat kan ik doen? (Thuisarts.nl)

Herhaal recept

Spoed telefoon

Inschrijven

Moet ik naar de dokter?

Afspraak maken

Wat kan ik doen? (Thuisarts.nl)

Herhaal recept

Spoed telefoon

Inschrijven

Schrijf uzelf in bij onze praktijk.

Inschrijven

Identiteitscontrole:

Woonverband:

Medische anamnese:

Gegevens vorige huisarts

Gegevens uitwisselen:

Locatie Maaspoort

Locatie Empel