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Emma Kinderziekenhuis AMC Amsterdam

Neonatology

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Department	Neonatologie
Hospital	Emma Kinderziekenhuis AMC Amsterdam
First name of your child:
Your account	What is your relation to the child? Mother Father Guardian (male) Guardian (female) Grandmother Grandfather What is your birthdate? dd-mm-yyyy Your e-mail address: Is there someone else taking care of the child? Yes No What is his/her relation to the child? Mother Father Guardian (male) Guardian (female) Grandmother Grandfather What is his/her birthdate? dd-mm-yyyy If you want to create a separate account (with a separate password) for this person please fill in his/her e-mail address. When this field is left blank you will share a single account.
Date of birth of the child	dd-mm-yyyy
Gender	Boy Girl Other
Terms	I agree with the terms and conditions of KLIK
Patient number	Please fill in your child's patient number at the hospital. If you don't know this number you can leave it blank.
Datum nazorg poli:	I don't know the next appointment with the doctor yet. dd-mm-yyyy
Practitioner	Search practitioner: Céleste Laarman dr. A.G. Leemhuis Dr. T.R. de Haan Sintha Sie T. de Baat No search results
What was the calculated birth date?	dd-mm-yyyy