The Netherlands Health Declaration Form

The Netherlands Health Declaration Form is a legally binding document that is used by Dutch residents to obtain private medical information. Anyone can complete this form and take it to a healthcare provider, who in turn will deliver it to the National Office, which will match the data in the form to a database and verify the individual's health condition. The data will be reviewed by the insurance company, who will decide whether to approve or deny your application. However, if you do not wish to give your health information to anyone, you can simply mail the form to your personal email account.

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