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Adress

Adress Orthopedium

Olof Palmestraat 20
2616 LS Delft
The Netherlands

Tel.: +31 (0)88-0088444
Mail.: info@orthopedium.nl
Fax: +31 (0)88-0088445

Request an appointment

To schedule an appointment, please call us at telephone number +31 (0)88-0088444 or complete the online form below. An Asterisk means the field is required.

One of our appointment schedulers will respond to your request as soon as possible.

Please don’t use this form if you have an urgent medical problem or to re-schedule an existing appointment.

Your complaint

Which joint*

At what side is the joint located?*
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Description of your complaint

General practitioner and insurance

Insurance company*

Name General practitioner *

Contact information

Title*

 Sir

 Mrs

Initials*

Surname*

Maiden name

Day of birth*
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E-mail adress*

Home phone / Cell phone*

Adress information

Street

House number*

Zip code*

Remarks

Remarks
Please fill in additional information concerning your request. This form is not suitable for medical questions.  Max. 160 icons

Please Note: Any information submitted using this form is transmitted securely and held in strictest confidence, protecting your privacy.

Contact me

Would you like to be called back?
Please complete this form and one of our staff members will contact you during office hours at a for you preferred time of day.

Route

Feedback

We are committed to a continuous review and improvement of our care and services provided to you as our patient. We welcome your ideas, comments and may be you have complaints.
Please give us your feedback providing valuable information in relation to the quality of our care and services.
Many thanks for your feedback.

If you have a specific question or concern, please contact us. See our Contact page of Callback form.