To make your visit to EFPC as safe as possible, we ask you to complete the visitor form.

Thank you in advance for your cooperation.

Dear (prospective) visitor,

The government and RIVM have promulgated measures about the Coronavirus. EFPC has prepared this instruction/registration for visitors. Please read it carefully and complete and sign the questions below.

When are you not welcome at EFPC?

  • if you are infected with the Coronavirus;
  • if you are a housemate of patient(s) with Coronavirus;
  • with (mild) cold symptoms, sneezing, sore throat, runny nose, light coughing or an elevation above 38 degrees;

If you are not sick and do not belong to the above groups of people, then you are welcome at EFPC.

Measures social abstinence

  • Please remember to keep enough distance from each other (at least 1.5 metres).
  • Visitors will receive visitor instructions and should register.


  • Soap is placed at each sink.
  • Paper towels are placed at each sink.
  • Paper handkerchiefs are placed on the tables for sneezing.

Other recommendations

  • Wash your hands regularly.
  • Cough and sneeze into the inside of your elbow.
  • Use paper tissues for sneezing.
  • Do not shake hands.


  • Posters have been put up at entrances and workplaces.
  • Visitors are informed of EFPC’s measures by our staff.

To know more,

Up-to-date information on Corona virus and what you can do yourself can be found at EFPC follows RIVM guidelines and keeps a close eye on developments. If you have any questions, please get in touch with your contact at EFPC.

    Gegevens bezoeker

    Aanhef * HeerMevrouw

    Achternaam *

    Voornaam *


    Naam bedrijf *

    Heeft u de instructie gelezen?


    Bent u besmet met het Coronavirus of bent u huisgenoot van patiënt(en) met het Coronavirus?


    Heeft u (milde) verkoudheidsklachten, niezen, keelpijn, loopneus, licht hoesten of een verhoging boven de 38 graden?


    Door gebruik te maken van dit formulier gaat u akkoord met de opslag en verwerking van uw gegevens.

    * Did you answer ‘Yes’ to questions 4 and/or 5? If so, you will not be able to visit EFPC and we will be happy to assist you by phone, Skype or MS Teams.

    This completed form will be destroyed after 14 days.