Forms for your HollandZorg health insurance
On this page, you will find all the forms you need to manage your health insurance policy yourself. You can change your personal details, submit a claim or apply for certain forms of care. Most forms are available in multiple languages. That's one of the advantages of HollandZorg.
Looking for forms for 2024? You'll find them here.
Update your information
- Change your address (My HollandZorg)
- Change your personal information (name, e-mail, telephone number) (My HollandZorg)
- Change your payment details (bank account, means of payment) (My HollandZorg)
Claim forms
- Expense claim - English
- Expense claim - Dutch
- Expense claim - Polish
- Claim form transport costs - English
- Claim form costs home dialysis - Dutch
- Claim form home respiration - Dutch
Application forms
- Patient transport - Dutch
- Non-contracted home care - Dutch
Third party authorization
Would you like to authorize someone to have access to your basic health insurance details? Then please complete and sign the form below.
- Third party authorization form - English
- Third party authorization form - Romanian