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If you intend to start up as a freelancer/self-employed professional (zzp-er) in the Dutch health care sector, you must contend with various government rules and regulations. You can use this checklist to quickly determine which obligations you must fulfil. This checklist covers rules for freelance/self-employed health care practitioners in the homecare sector and for health care practitioners who set up their own practice, such as dentists and physiotherapists.
This checklist is merely a guideline. Several steps can be carried out at the same time. Depending on your specific health care profession, you may also be subject to other obligations.
1. Check whether you fulfil the conditions for staying in the Netherlands
Entrepreneurs who intend to stay in the Netherlands must fulfil a number of conditions. You will sometimes also require a residence permit.
If you plan to start doing business in the Netherlands, you may also want to apply for a business bank account (IBAN). The Dutch Banking Association has created a Quick Scan to help you find out if you are eligible. Read how it works.
2. Demonstrate you are self-employed with a model agreement
A model agreement between you and your client will enable you to demonstrate that you are truly an entrepreneur. In that case, your client does not have to pay contributions or payroll taxes.
3. Register yourself with the BIG Register
You must be entered in the BIG register to be allowed to practice certain health care professions as a freelancer/self-employed professional. You are not allowed to use the legally protected professional title until you are in this register.
4. Provide insured health care
As a freelancer/self-employed professional, you can provide your clients with care in two ways: via an approved institution or by concluding an agreement with a care administration office.
5. Meet the quality requirements
The care you provide, must meet the care quality requirements set by law.
6. Set your rates
The Dutch Health Care Authority sets maximum rates for certain independent health care professions. Many health care services are exempt from VAT. Freelancers/self-employed professionals, partners in a company and care agencies use the 21% rate.
7. Draw up general terms and conditions
General terms and conditions include rules about payment, delivery times, guarantees and disputes. You can use the specimen terms and conditions drawn up by the Chamber of Commerce (KvK).
8. Take out the insurances you need
You are obliged to take out health insurance in the Netherlands. You also have the option of taking out insurance against a number of other risks (including business risks).
9. Report your home business
If you plan to run a business from your home, you are normally obliged to report this plan to your local municipality. You must also bear in mind various tax issues.
10. Create a patient file
Health care practitioners are required to keep records for each patient. These records contain various details including the patient’s health and the treatment prescribed by the health care practitioner.
11. Report child abuse and domestic violence
If you are suspecting child abuse or domestic violence, you have to use a reporting code.
12. Register with the Dutch Commercial Register and Dutch Tax Administration
New businesses must be registered with the Dutch Commercial Register. They will pass on your details to the Dutch Tax and Customs Administration. You therefore do not need to register separately with them.
13. Fill in the Dutch Health Care Inspectorate's questionnaire
After registration with the Dutch Commercial Register, the Dutch Health Care Inspectorate (Inspectie voor de Gezondheidszorg, IGZ) will ask you to fill in a questionnaire (in Dutch). They use this questionnaire to determine if your care institution falls under their supervision.
Statistics: self-employment in human health activities
Number of self-employed persons in human health activities.