Paediatricians are specialists in hospitals that can only be visited with a referral letter from your GP. The Consultatiebureau or baby health clinic provides basic paediatric care. The clinics are staffed with specially trained doctors and nurses who offer routine paediatric care and immunisations. They monitor the growth and development of your child from birth up to the age of four. To use their services, you must be a member of the Stichting Thuiszorg (886 00 00), a Home Care Association that offers medical, social and preventive medical services. They will refer you to the nearest health clinic for your child's check-ups. After the age of four, your child’s records are then sent to the school health service where your child’s development is monitored by your local GGD (Gemeentlijke Gezondheids Dienst) health service (555 59 11). The GGD will send you a card with an appointment for your child’s examination or immunisations when they are due. If you would prefer your GP to administer your child’s immunisations, this can also be arranged. Doctors from the GGD perform physical examinations that include eye, coordination, hearing and speech tests, and also monitor your child’s growth. These GGD exams begin when the child is five years old and continue with two more exams between the ages of six and twelve. During secondary school they will undergo one or two more examinations. The Consultatiebureau and GGD are no substitute for your GP, as they cannot prescribe medicine; they can only recommend non-prescription medications and treatments for minor childhood complaints. There are several stages of immunisation: DKTP (Diptheria, Whooping Cough, Tetanus and Polio) and HIB (Haemophilus Influenzae Type B) at two, three, four and 11 months; BMR (Measles, Mumps and Rubella) and Meningitis at 14 months; DTP (Diptheria, Tetanus and Polio) at four years; DTP (Diptheria, Tetanus and Polio) and BMR (Measles, Mumps and Rubella) at nine years.