Registration and onboarding

Will you soon be starting work at Maria Middelares General Hospital as a physician-specialist in training? Please complete this questionnaire as completely and accurately as possible, at least four weeks before the start of your internship.

Many thanks for providing your information, and please feel very welcome in our hospital!


Free assistants contact Saïs Walenta via Interns (sixth-year master's degree in medicine) register via the student section (Go to Professionals > Interns and students).

General information

Address details (domicile)

Contact details

For example: +32 XXX XX XX XX

Bank account number


Marital status

You are obliged to state your partner below. Even if you are unmarried, but have a partner, please complete the fields below. If you do not have a partner, fill in the fields below with 'NA' (Not Applicable).


Upload a passport photo below (jpg). We expect a professional photo, in accordance with the standards as on your identity card. This means in civilian clothes with a neutral, white background. The photo is necessary to create your badge.

You will receive a confirmation email after you have successfully submitted this form. Be sure to check the spam folder in your inbox.