Parents, children and adolescents The Children's Hospital (HUDERF) makes every effort to care for and support every child and adolescent, alongside the parents and loved ones. Learn More
Professionals The Children's Hospital (HUDERF) works with a wide range of health and care professionals, organisations and institutions. Find all the information you need here! Learn More
Breadcrumb Current: Home Online appointment form Child's contact details First and last name Address Postcode City Date of birth Parents are As a couple Separated Agreement of both parents Yes No Mother's contact details Phone number Email Father's contact details Phone number Email Telephone number of a support person Language French Dutch English Arabic Spanish Italian Reason for request Therapist required (speciality/name) Who referred you to HUDERF? (profession/institution) Is your child already being treated at HUDERF? Yes No If yes, please provide details What is your Belgian mutual? Name of paediatrician or general doctor + postal address The child attends a school In French In Dutch Have you ever had a consultation with a child psychiatrist - neuropaediatrician - psychologist - neuropsychologist - speech therapist? Yes No si oui, merci de nous transmettre les éventuels rapports Maximum 3 files.5 MB limit.Allowed types: jpg, jpeg, png, psd, txt, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, gz, jar, rar, tar, zip. Is the ENT check-up in order?
