Afspraak maken | Podotherapie Van der Pas

You can fill in the form below to make an appointment. Indicate your preference for a location and time of day, and we will try to take this into account as much as possible. We will contact you by phone to schedule a date and time.

Surname *

Initials *

Date of birth *

I am a *

Man

Woman

Address *

E-mail address *

Your e-mail address is needed for appointment information and invoice

Phone *

Preferably your mobile number

The reason for visiting our practice? *

Preventive foot care, determining care profile

Fitting podiatric insoles

Adjusting podiatric soles or orthotics

Otherwise:

Appointment Request