Fields marked with a mandatoryare mandatory

Make an appointment

Online appointment request for testing:

We will assess your application according to the criteria that the RIVM (National Institute for Public Health and Environment) have established to carry out a test. Your application may lead to an appointment at the STD out-patient clinic, but you may also be referred to your GP or another agency. In order to determine this, you must complete the questionnaire completely. Answer the questions as carefully as possible. Your information will be treated confidentially. Completing the application takes 5 to 15 minutes.
It is possible that there are no more possibilities for an appointment when you have finished the questionnaire. You can submit a new appointment request at another time. We ask for your understanding.

You can do a STD test every six months.
What is your date of birth?
What was the sex you were registered with at birth?
Do you identify yourself with a different sex than the one you were born with?
What sex do you identify with?
Did you had a sex reassignment surgery (vaginal construction)?
Did you had a sex reassignment surgery (penis construction)?
What is your postal code?
Why do you want to make an appointment?

Personal information

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