Registration form

Registration form


Due to the long waiting lists within speech therapy, we will apply a (temporary) zip code policy from September 18, 2023. This means that we only accept registrations from people living, working or going to school in Amsterdam Zuidoost, Diemen, Abcoude, Vinkeveen, Wilnis, Baambrugge, Mijdrecht, Driemond and Weesp (preverbal therapy only).

Currently we have a waiting list of about 4-6 months.

After filling in the form, you will receive a confirmation. Did you not receive an e-mail, please check your spam-folder.

Fill in the form below with the details of the person you are registering.

Aanmeldformulier ENGELS
Gender *
Preferred days *
Do you have a referral letter?