We are available by phone Monday through Friday from 8:30 a.m. - 1:30 p.m. 
0184 - 613 782 
info@silderhuislogopedie.nl 
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Silderhuis Logopedie
Application form

cropped-Silderhuis-Logopedie-Beeldmerk-2024-transparant.webp  silderhuis speech therapy

You can easily apply using the application form below. Upon receipt of your application, we will contact you as soon as possible (within two business days) to discuss further steps and schedule an appointment at one of our locations.

We value your privacy and will handle any information you enter with care and discretion. Your personal information will only be used for processing your application and organizing the best possible care.

Waiting lists in Uithoorn and Mijdrecht

Due to increasing waiting lists in Uithoorn and Mijdrecht and a shortage of new colleagues, we advise you to register with other speech therapy practices as well. We advise you to notify your health insurance company by e-mail. If you send us a message, we will be happy to send you a standard letter that you can forward to your health insurance company.

Enter your name here

First name
prefix
Last name

Who do you want to sign up?

Client name
Date of birth
What is the gender
Fill in the answer you feel most comfortable with. This does not have to be the same gender as on your passport. The answer to this question will be processed in accordance with the General Data Protection Regulation and will only be used for Emancipation purposes, such as monitoring the gender balance within our organization. You may change or withdraw your answer at any time.
I identify myself as
Address
Zip code
City
Email address
Phone number
General practitioner
Social security number
You do your application through
Please indicate whether you are making this application through DTL - Direct Access Speech Therapy (Click here for explanation) or with a general practitioner referral. Select “DTL” if you do not have a physician's referral. Select “A general practitioner referral” if you have been referred by a general practitioner.
Referral by
Please specify who referred you.
What is your health insurance company
Health insurance number
Preferred location
Are you open to online treatment?
What day and times are you available (multiple options possible)
Time monday
Time tuesday
Time wednesday
Time thursday
Time friday
Help Request Description
Describe your question, comment or complaint(s) above