Registration practice You can only register with us when you live in our service area. This is within the highway A10, with the exception of Amsterdam North. * = verplicht veld "*" indicates required fields First name* Surname* Gender* m v Date of birth* Day Month Year Insurance* Insurance number* Did you get the flu shot from your previous doctor? If so, for what reason?* ja nee Reason if flu shot received Street* House number* Addition Postal Code* Citizen service number* Phone number*E-mailadress* Name of previous GP* City of previous GP* RemarksPermission* I hereby confirm my registration with Huisarts aan de Herengracht and I give them permission to deregister me and to request my medical data from my previous GP.