Documents for students


Application samples for students

In case you would like to apply to your respective Dean (Dean's Leave, prolongation of an examination session, payment deadline, etc.), please follow the format given below. The application can be written by hand, printed out or sent as an e-mail main body/ document attachment (.doc or scan).

Medicine - a form to be filled in

Dentistry -  a form to be filled in


Student Card duplicate request - a form to be filled in

Clearance slip* - a form to be filled in

*from academic year 2019/2020 clearance slip should be signed electronically


MAP - Clinical Hospital no. 1 (Unii Lubelskiej)

MAP - Clinical Hospital no. 2 (Pomorzany)


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Pomorski Uniwersytet Medyczny w Szczecinie

ul. Rybacka 1, 70-204 Szczecin,
tel. 91 48 00 700 / 800, fax 91 48 00 705
NIP 852-000-67-57, Regon 000288886