Referral forms for medical foot care

Would you like to receive a pad of 25 referral cards for medical foot care? If so, please complete the form below. We will post the pad to you within a few weeks.

You can refer your patients to one of our podiatrists using the referral forms. Complete the form and give it to your patient. The patient should hand the form to the podiatrist during their first appointment. You can also refer your patients via ZorgDomein. Please note: Without a referral, the patient cannot book an appointment for medical foot care.