Zbąszyńska street 32/3, 60-359 Poznań, phone: +48 61 8436000
The Form for control visit registering
The control visit form is dedicated for persons who were on the visit within last 6 months
In order to register the control visit, please write your call number from your former registration, your phone number and your e-mail address
(identical as in the former registration call)
The date of the former visit must be later than 6 months ago.
If something doesn't work write to: rejestracja [Q] drmichalak.pl
Number of the former call:
email:
* as in the former call
write e-mail again:
Telephone:
anti-spam
rewrite blue letters without dots:
*
a.s.w.e.j.k
