SAG Health centers
SAG Dutch version
Online registration form
SAG Banne Buiksloot
Date of birth
Citizens Service Number (CSN)
Do you have a CSN number?
Phone number 1
Phone number 2
I don't have a Dutch health insurance
Name health insurance
Do you give us permission to use your mobile phone number for our sms service?
Do you give us permission to use your email address for our email service?
Participation Landelijk Schakelpunt (National Exchange Point)
Do you give the health center permission for making your medical information available through the LSP with other caregivers?
I have read the brochure
'Electronic sharing of your medical data?
Only with your permission!'
Online patient portal
Our health center has an online patient portal. Via this portal you can make appointments, request repeat prescriptions and conduct an eConsult with your doctor. Do you want to use this service? Then take the following steps: create a new account in our patient portal click within 24 hours on the confirmation link in the e-mail you receive your account details will be compared to the details already known to us. In case of uncertainties we will contact you to complete the registration after completion we will activate your account and you will be able to use our online services.
I don't have a former GP
Name of former GP
City of former GP
Do you give us permission to obtain your medical file from your former GP?
Preferred gender of the GP
I agree to my registration for this health center
Location email address