Starting as a healthcare professional in the Netherlands

Published by:
Netherlands Enterprise Agency, RVO
Netherlands Enterprise Agency, RVO
Netherlands Chamber of Commerce, KVK
Netherlands Chamber of Commerce, KVK
Statistics Netherlands, CBS
Statistics Netherlands, CBS

If you intend to start up as a freelancer/self-employed professional (zzp'er) in the Dutch healthcare sector, you must comply with various government rules and regulations. You can use this checklist to determine which obligations you must fulfil.

This checklist covers rules for freelance/self-employed health care practitioners who want to set up a healthcare in-home business, and for healthcare 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 healthcare profession, you may also be subject to other obligations.

1. Check whether you fulfil the conditions for staying in the Netherlands

To start a business and settle in the Netherlands, you may need a residence permit. Our interactive tool Coming to the Netherlands as an entrepreneur can help you find out quickly if this is true for you, and what other obligations you have to fulfil.

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. Register with the BIG Register

Certain health care professions have a protected title. You must be entered in the BIG register to be allowed to practice these professions, provide health care services, and use their legally protected professional title in the Netherlands. This requirement is in addition to your educational degree and professional requirements.

3. Register with the Dutch Business Register and Netherlands Tax Administration

New businesses must register with the Netherlands Chamber of Commerce (KVK) Business Register. The KVK will pass on your details to the Netherlands Tax Administration. Within two weeks you will receive your VAT identification number and your VAT number from the Tax Administration by post. Read more about these VAT numbers.

4. Fill in the Dutch Health Care Inspectorate's questionnaire

After registration with the Dutch Business Register, the Dutch Health Care Inspectorate (Inspectie Gezondheidszorg en Jeugd, IGJ) will ask you to fill in a questionnaire (in Dutch). They use this questionnaire to determine if you, your care institution, falls under their supervision.

5. Register as a new healthcare provider

As a new healthcare provider in the Netherlands, you are obliged to register with the CIBG (in Dutch). This government organisation is part of the Dutch Ministry of Health, Welfare and Sports. You need eHerkenning for this. Please note: you can only register after the start date of your company.

6. Apply for an AGB code

Do you want to provide your clients with insured care? This is care that is insured under the Health Insurance Act (Zvw) and the Long-Term Care Act (Wlz). Then you need a personal AGB code to declare the care you provide. That way you know you are getting paid for the care you provide, and that your patient will be reimbursed (in part) for the care. You can only apply for an AGB code if you have a valid BIG registration or registration from a professional or quality register. The organisation managing the AGB register is Vektis. You can find all the relevant information on registering for AGB on (in Dutch).

7. Apply for a certificate of conduct (VOG)

In health care you need a Certificate of Conduct (VOG). You can apply for this digitally at your municipality. With a VOG you prove that your behaviour in the past is not an objection for performing your work.

8. Meet the quality requirements

The care you provide, must meet the care quality requirements set by law. You can use this self-test and exception list (in Dutch) to check whether you must meet the requirements of the Care Sector Quality, Complaints, and Disputes Act (Wet kwaliteit, klachten en geschillen zorg, Wkkgz).

Do you fall under the Wkkgz? If so, you must register with the Health Care Inspectorate before you can start. This is mandatory according to the Care Providers Entry Act (Wtza).

Comply with the Wzd in the event of involuntary care

Do you provide involuntary care for patients diagnosed with dementia or a mental disability and fall under the Wkkgz? If so, the Care and Coercion Act (Wet zorg en dwang, Wzd, in Dutch) applies. This law protects patients from the disadvantages of involuntary care. Care for these people must be as voluntary as possible. If there are no alternatives, you must follow the Wzd step-by-step plan (in Dutch). The responsibilities of the Wzd lie with you as a freelancer. You must register with the location register (in Dutch). Registration is necessary to act with care and to evaluate the measure. In addition, you must report each year (in Dutch) to the Health Care and Youth Inspectorate (IGJ).

9. Set your hourly rates

The Dutch Health Care Authority sets maximum rates (in Dutch) 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.

10. 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).

11. 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 business-related risks:

Business liability insurance (Bedrijfsaansprakelijkheidsverzekering) protects your business against damage caused by your work, products, and in other situations. Any business that comes into contact with others can cause damage and be liable for it.

Medical professions that require a Higher professional Education (HBO) or university degree often require a Professional indemnity insurance (Beroepsaansprakelijksheidsverzekering). This covers the financial damage of any professional error you make, for example, a wrong diagnosis.

With a Business legal expenses insurance (rechtsbijstand) you are insured for legal assistance in the event of a conflict with suppliers, employees, or customers.

As a self-employed healthcare professional, you will not have any income if you fall ill and cannot work. Theoccupational disability insurance protects you if you fall ill or sustain an injury that prevents you from working.

12. 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.

13. 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. Please note: medical data are special personal data, and you need to take measures to keep them safe. Read what to do to comply with the GDPR.

14. Report child abuse and domestic violence

If you are suspecting child abuse or domestic violence, you have to use a reporting code.

15. Avoid false self-employment

As a self-employed professional or freelancer in the Netherlands, you may be in the situation that you work in someone else's practice for a while. The company giving you the assignment is then your business client (N.B.: not to be confused with private individuals, who receive care). The question may arise: are you really self-employed, or is it false self-employment? Check with your client whether you are taking on an assignment as salaried or self-employed. To prove that you are independent, you can use a model agreement between you and your client.

Overview step-by-step guides

Which profession do you want to pursue in healthcare? Each profession has its own laws and regulations. In this overview, you will find step-by-step guides for common types of professions:

Statistics: how many self-employed professionals start in healthcare?

The graph shows the number of self-employed professionals starting a business in the healthcare sector.

Questions relating to this article?

Please contact the Netherlands Enterprise Agency, RVO