Register First Name:*Surname*Date of Birth*Telephone number*Street*House number*Zip Code*Town*Insurance Document*Upload here a photo of your AON complete insurance or EHIC card (the blue side!)E-mail Address*Choose your pharmacy where you pick up your medication:*Pharmacy HanzepleinPharmacy PaddepoelPharmacy SelwerdPharmacy DiephuisPharmacy BoterdiepPharmacy De WiljesPharmacy HelpmanPharmacy OosterpoortPharmacy VenemaPharmacy BeijumPharmacy Vinkhuizen