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Submit by Email The Statement of Health (Value 2008: 31,80 19,95 + 11,85 administration fee incl. 19% VAT) If you are under 70 years of age, and you submit a first time application for a Dutch driving
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Gather all relevant personal and medical information.
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Read and understand the instructions provided with the form.
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Start by providing your personal details like name, address, and contact information.
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Fill out the sections related to your medical history, including past illnesses, surgeries, medications, and any ongoing treatment.
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Be honest and accurate while providing medical information, as any false information can lead to rejection or complications.
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Who needs statement of health form?

01
Individuals applying for health insurance policies generally need to fill out a statement of health form.
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People seeking life insurance coverage or disability insurance may also be required to complete this form.
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Some employers may require a statement of health form from their employees, especially if they provide group health insurance benefits.
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Individuals applying for specialized health programs or government assistance related to medical conditions may need to fill out this form.
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The statement of health form is a document that provides information about an individual's current health status.
The statement of health form is typically required to be filed by individuals applying for health insurance or life insurance.
To fill out the statement of health form, individuals must provide accurate information about their medical history, current medications, and any existing health conditions.
The purpose of the statement of health form is to help insurance companies assess an individual's risk level and determine the appropriate premiums.
Information such as medical history, current medications, existing health conditions, and contact information must be reported on the statement of health form.
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