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A GP referral is not required

When you register for the first time, the assistant will create your own pregnancy file and you will immediately receive reliable and useful information important to you at the beginning of your pregnancy. Everything you share with us is confidential; we handle this very carefully. The information requested is important to provide you with the best care, tailored to your needs. The form consists of 3 steps, please fill it out as completely as possible.

    Step 1 - Personal details





    Date of birth/country












    All the attention, most knowledge and experience in one place

    Philips as a high-quality echo partner

    Step 2 - Pregnancy

    First day of your last menstruation




    How is your cycle?


    Additional information

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    Always close to you in Eindhoven, Aalst and Waalre

    Step 3 - Partner

    Is a partner involved?



    Date of birth of partner








    Read in our privacyverklaring how we process the data from this form.

    Unique consultation with gynaecologist

    For 50 years for you, personally