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New patient registration

New patient
regitstration

Dr Anne Perrin-Albu

Please fill-in the form below. You will then be able to immediately make an appointment as an “existing patient” via the calendar.
Your information will be treated securely and confidentially.

We need accurate information in order to create your child’s medical record. Please check the accuracy of the information you have provided before confirming this registrationIncorrectly entering your child’s insurance number (always starting with “807…”), your email address or your telephone number will automatically result in the cancellation of the appointment you have made.

You can also contact us by phone at 079 703 49 07 between 10:00 and 10:30 AM and between 7:30 and 8:00 PM if you need additional information. If we are busy seeing patients, please leave a message on the answering machine and we will call you back as soon as possible.

Due to logistical constraints, we only see children who live in a building with an elevator or who live on the first floor.

If you are unable to attend, please inform us at least 24 hours in advance (by cancelling the appointment yourself on the OneDoc platform) so that we do not have to charge you for the time reserved for the consultation.


Patient (child) information



Child’s legal guardian