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Registration form PrEP care GGD Amsterdam

The PrEP care of the GGD Amsterdam has limited capacity. U can apply for the waiting list.PrEP care is also available through your general practitioner.

For more information please see https://www.ggd.amsterdam.nl/english/sti-hiv-sense/prep/

This form is secure and your information will be treated confidentially.

Personal data
4 numbers without the letters, if you do not have a permanent residence: enter “1000”
What is your assigned gender at birth?
Do you feel different than the gender you were assigned at birth?
Flag as appropriate:
Other declarations of consent

By registering, I declare that I completed this form truthfully and am aware that this may be checked during my appointment. I am aware that an appointment is no guarantee for participation in the PrEP Care programme via GGD Amsterdam.