By filling out the form below you can transfer your data to our clinic. For each patient we would like you to use a separate form. The information will be treated confidentially.

Once we have received the information, we will register your patient as a patient at Het Tandenrijk, and will contact you to make an appointment.

You can refer your patient here

Our practice is open for new patients starting February 1th 2020. Untill then, we kindly refer you to Kindertand Rotterdam.

Personal data referring Dentist

Personal data Patient