PLEASE NOTE!

Please ensure that all required information (e.g. company name, NIP or REGON, Patient's personal data, type of medical examination) is provided in the referral.

The attachment size cannot exceed 10 MB.

The response time is 3 working days

The controller of your personal data is LUX MED sp. z o.o., with its registered office in Warsaw 02-676 at ul. Postępu 21 C (hereinafter "LUX MED"). We process your data contained in this form to enable you to enrol for selected occupational medicine examinations in accordance with the referral issued. In order to verify your identity and arrange contact, we need to receive data from you including your first name, surname, city, type of research and, depending on the form of contact chosen, your e-mail address and/or telephone number. Remember that you can also attach a referral with your application. In all matters related to the processing of your personal data you may contact our Data Protection Officer by writing to daneosobowe@luxmed.pl. Click here to read the full text of the information obligation.

The LUX MED Group provides services for occupational medicine only for companies with a signed agreement

When completing the form, please send the medical examination referral – failure to provide the medical examination referral will prevent the relevant registration. Reservations for examinations via the Patient Portal and the contact form are made only at LUX MED Group's own facilities. If you want to arrange an examination at subcontractor facilities, please refer to the list of these on our website or call 22 33 81 666.