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:



  * as in the former call

write e-mail again:



  * as in the former call



rewrite blue letters without dots: