Click on Žádost dle § 42 eng.doc (available when you scroll down)

Fill the application form as follows:
Page 1:

• Circle part a) that the basic qualification...
• fill in all required data
  Notes:
  • Former surname – for women only. Fill in this box if you married and your surname has changed.
  • Place of birth – write your city and state of birth.
  • Country for which the ‘Certificate’ will be issued: Select the country where you are planning to practice (this question is for statistical purposes only).
  • Address of permanent residence – your official address abroad – usually written in your passport. The Ministry will send your certificate to this address if you don’t specify a different contact address.
  • Contact address – fill in this section if you want the Ministry to send your certificate to a different address than your permanent residence.

• circle part a) basic qualification and fill in the required data

Page 3: Ignore

Print the application and sign and date it (on page 4).

Enclose:

• An officially verified copy of your university diploma
• An officially verified copy of the state examination certificate or diploma supplement
• A copy of your identification card
• A copy of your marriage certificate (only for women who have changed their name)
• A 500 Kč stamp (kolek), which is available at post office. You can also transfer the fee from your bank account. The Ministry account number is 3711-000252800, bank code 0710. Use the variable symbol 2915 and write your name and surname as additional information.

Send or deliver this paper and other documents to

Ministerstvo zdravotnictví ČR, Palackého nám. 375/4, Praha 2, 128 00

Office hours (for the Podatelna):

The responsible person is

Marie Pláteníková

+420 224 972 915

The issuing process lasts approximately 30 days from the day you submit your application. The Ministry of Health provides a service to post the certificate to abroad for free. The certificate is issued in the Czech language.