New patients

How to register as our patient

To receive family doctor care at Teledoctor, you need to submit a declaration of choice. There are several ways to do this — at a clinic or online. Each is free under NFZ funding.

At the clinic

  1. Visit reception during opening hours — you do not need to book or notify us in advance.
  2. Please have your PESEL number with you. When registering a child, bring the child’s PESEL number.
  3. Complete the declaration at reception.

Reception: Monday–Friday 8:00–18:00

Online

You can also submit your declaration electronically through Internetowe Konto Pacjenta (IKP), Poland’s online patient account, without visiting the clinic.

Internetowe Konto Pacjenta (IKP) is run by Poland’s Ministry of Health.

Go to pacjent.gov.pl

Using our form

The form on our website fills in the declaration for you and creates a ready-to-use file on your device. Sign it with a Polish trusted signature (podpis zaufany) and email it to us.

The information you enter is not sent to our server — the document is created in your browser.

Complete the declaration online

Download the form

The declaration template is set out in the Minister of Health’s Regulation of 26 June 2020 and is the same throughout Poland. The file comes from the National Health Fund (NFZ) website and contains templates for choosing a doctor, nurse and midwife.

You can complete the form at home and bring it to reception. This is optional — we can fill it in together at the clinic.

Download the declaration form (PDF) (in Polish)
You submit your declaration to Teledoctor, not to a particular address. Once registered, you can use both our clinics — at ul. Zielona 29 and ul. Paderewskiego 47.

Przychodnia Plac Barlickiego

ul. Zielona 29, 90-602 Łódź

Reception: Monday–Friday 8:00–18:00. Assistance in Polish, English and Ukrainian.

42 640 65 23

Przychodnia Górna

ul. Paderewskiego 47, 93-523 Łódź

Reception: Monday–Friday 8:00–18:00. Assistance in Polish.

42 640 25 14

Do you have questions before submitting your declaration? All ways to contact reception are listed on the page “Book an appointment”.

PLENУКР