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E-Declaration

For this purpose, after logging in to the Patient Account website, in the MOJE KONTO [MY ACCOUNT] tab, you can submit an E-DECLARATION to the doctor and/or nurse.
After entering MOJE KONTO [MY ACCOUNT], scroll to the bottom of the page, and select TWOJA PODSTAWOWA OPIEKA ZDROWOTNA [YOUR PRIMARY HEALTH CARE] (POZ).Here are presented the possibilities of making a declaration to the doctors and nurses currently working in our clinic.

If there is a doctor’s name there associated with our clinic – ul. Nowoursynowska 161, 02-787 Warsaw, it means that the declaration has already been made in another form, correctly submitted in our facility, and you can skip the next steps.

If the field is empty or if there is a doctor outside  of the list below, enter the new name of one of the doctors assigned to our facility – below is a list of doctors associated with NZOZ SGGW.  Follow the instructions step-by-step

CHANGE OF DOCTOR:

  1. In the Doctor box, click New Declaration / Enter Declaration.
  2. Verify/complete your data.
  3. Select a facility:
  • Województwo Mazowieckie [Mazowieckie Province]
  • Miejscowość Warszawa [Warsaw]
  • Ulica Nowoursynowska  [Nowoursynowska Street]
  • Placówka NIEPUBLICZNY ZAKŁAD OPIEKI ZDROWOTNEJ SGGW (GABINET LEKARZA POZ) [NON-PUBLIC FACILITY SGGW HEALTH CARE FACILITY (DOCTOR’S OFFICE POS)]
  1. Choose a doctor (currently working POZ doctors in our facility) – you can choose one name:
  • Agnieszka Zofia Szymańska
  • Alicja Bozena
  • Iwona Maria Witek
  • Malgorzata Maria Kaczorowska
  • Sylwia Maria Gruber
  • Adam Joseph Kalinowski
  1. Click PODPISZ DEKLARACJĘ  [SIGN DECLARATION] and follow the information that appears.

CHANGE OF NURSE:

  1. In the Nurse box, click  Nowa deklaracja / Wprowadź deklarację. [New Declaration / Enter Declaration.]
  2. Verify/complete your data.
  3. Select a facility:
  • Województwo Mazowieckie [Province: Mazowieckie]
  • Miejscowość: Warszawa [City: Warsaw]
  • Ulica: Nowoursynowska [Street: Nowoursynowska]
  • Placówka NIEPUBLICZNY ZAKŁAD OPIEKI ZDROWOTNEJ SGGW (GABINET LEKARZA POZ) [Facility: NON-PUBLIC HEALTH CARE FACILITY SGGW (NURSE’S OFFICE)]
  1. Choose a nurse (currently working nurses in our institution) – you can choose one name
  • Renata Chmielewska
  • Anna Sokulska – Ksyta
  • Beata Katarzyna Jurek
  1. Click “Podpisz deklarację” [Sign Declaration] and follow the information that appears.

Once the e-declaration has been correctly signed, it will be submitted for acceptance in our clinic.
If you make an error, don’t worry – the system will generate an email to us, and we will take care of this matter.