Call us on: 088 00 17 121
Verhuisadvies

Sign up for Moving advice

Please note: At the start of the Moving Advice, the customer must sign a consent form for our assistance. 

Salutation *
Initials *
Name *
Date of birth *
Date of birth
Street name *
House number *
Postal Code *
Place of residence *
Phone number *

You can fill in the details of a possible contact person later

Email address *

Living situation

Living situation *

Desired help

Desired help *

Reason for wanting to move

Reason for wanting to move *
Describe in detail why you want to move.

Reason for requesting Moving Advice

Reason for requesting Moving Advice *
Explain why the use of Moving Advice is desirable. Clearly indicate why you cannot do it yourself and why the people in your network cannot help you.

Stakeholders

Stakeholders *
Are there any other people involved in supporting you? Think of the elderly advisor, neighbourhood team, district nurse, practice assistant of the GP, your informal carers or other volunteers. If applicable and with permission, also provide contact details.

Do you need help with administration or finances?

Do you need help with administration or finances? *

I need help with the administration by

I need help with the administration by
Enter who you are already receiving help from

Housing requirements

Housing requirements
Do you already have certain ideas about a home or living environment? For example, in a certain complex, neighborhood, living with care or near meeting opportunities? Then indicate that here.

Registration Entrance

Registration Entrance

Do you have a housing indication (priority)?

Lifelong housing indication (priority) *

Do you have a care indication (priority)?

Care indication *

What is the budget?

Budget moving *
Would you like to get in touch? *
Contact person name *
Contact person phone number *
Contact person email address *

By submitting this form the customer agrees to the registration of personal data for the purpose of providing services.

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We are available on working days between 09.00 am and 3:00 p.m.
Call us on 088 00 17 121

Sign up for Moving advice

Please note: At the start of the Moving Advice, the customer must sign a consent form for our assistance. 

Salutation *
Initials *
Name *
Date of birth *
Date of birth
Street name *
House number *
Postal Code *
Place of residence *
Phone number *

You can fill in the details of a possible contact person later

Email address *

Living situation

Living situation *

Desired help

Desired help *

Reason for wanting to move

Reason for wanting to move *
Describe in detail why you want to move.

Reason for requesting Moving Advice

Reason for requesting Moving Advice *
Explain why the use of Moving Advice is desirable. Clearly indicate why you cannot do it yourself and why the people in your network cannot help you.

Stakeholders

Stakeholders *
Are there any other people involved in supporting you? Think of the elderly advisor, neighbourhood team, district nurse, practice assistant of the GP, your informal carers or other volunteers. If applicable and with permission, also provide contact details.

Do you need help with administration or finances?

Do you need help with administration or finances? *

I need help with the administration by

I need help with the administration by
Enter who you are already receiving help from

Housing requirements

Housing requirements
Do you already have certain ideas about a home or living environment? For example, in a certain complex, neighborhood, living with care or near meeting opportunities? Then indicate that here.

Registration Entrance

Registration Entrance

Do you have a housing indication (priority)?

Lifelong housing indication (priority) *

Do you have a care indication (priority)?

Care indication *

What is the budget?

Budget moving *
Would you like to get in touch? *
Contact person name *
Contact person phone number *
Contact person email address *
By registering you agree to the General Terms and Conditions