With this form you sign up for the medication dispenser

The medication dispenser is available 24/7 and an extra service for you. So you can pick up your medication when it suits you: before work, without waiting in the pharmacy or in the evening on the way home.

By signing up for the automatic medicine dispenser you agree to the following conditions:

  • Your medication will be ready for you in the safe for a maximum of 48 hours. Then it is taken out and you can pick up the medication at the counter.
  • Medication that you get for the first time (or longer than one year have not used) you always pick up at the counter.
  • Medication that must be refrigerated, is too large or fragile, can not be in the safe and you get it at the counter.
  • Whether the medication is not reimbursed by your health insurance? Then you first pay by pin at the safe before the package is issued.
  • Do you need medication urgently? Then always pick it up during our opening hours. Outside opening hours, we can not solve problems such as malfunctions or incomplete delivery for you.
  • No rights can be derived from problems caused by the use of the medication vault.
Apotheek
Adresgegevens

Automatische incasso:
Niet alle medicijnen worden vergoed door je zorgverzekeraar. Ook kan het zijn dat je nog openstaande bestellingen hebt die betaald moeten worden. Door het formulier hieronder in te vullen, ontvang je maandelijks een betalingsoverzicht en wordt het bedrag automatisch van je rekening afgeschreven.

CAPTCHA
Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.