Course registration
Name
Email
Date of birth
How are you registered?
Please select the right option
I'm registered at GP office Janskerkhof/de Uithof in Utrecht
I'm registered at GP office UT Campus in Enschede
I'm registered elsewhere/I'm not sure if or where I'm registered
Streetname + housenumber
Phone number
For what course would you like to register?
Dealing with procrastination, starting February 22nd
Picture of your health insurance card (only required if you are not registered at GP office Janskerkhof/de Uithof or GP office Campus UT)
Comment or message
GDPR agreement
I consent to having this website store my submitted information so they can respond to my inquiry
Newsletter
I would like to receive email updates regarding future events (about once every month)
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