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(valid from 09.02.2017)
Payments at the clinic can only be made in cash. In case of tests or phone or Skype consultations, payment can be made via bank transfer, provided that a bank transfer confirmation is offered in person or via email. The reception desk does not have the capability to check the account to quickly confirm a payment.

Table of contents:

  1.  New patient registration
    I. Rules
    II. Questionnaire
    Basic information
    III. Registration procedure
  2.  Types of consultation
    I. Follow-up consultations
    II. Follow-up consultations via phone/Skype
    III. Follow-up consultations via phone/Skype in urgent matters
  3.  Cancelling a consultation
  4. Presence of the child during visits
  5. Contacting the clinic between visits
  6.  Additional services
  7.  Invoices
  8.  Important information
    I. Writing prescriptions during a visit
  9. Dietary consultation

1. New patient registration

I Rules:

1. The first consultation is only appointed after filling out the questionnaire and after being assigned tests by dr Cubala.*
– Patients, who do not wish to fill out the questionnaire for the purpose of test selection before their first visit, can only be signed in the reserve list, and can only receive an appointment in case of other patients’ not using their appointment. This does not guarantee availability of appointments or receiving a consultation.
*Applies to patients with diagnosed/suspected autism. Patients with other diseases are asked to contact us at

2. A consultation is scheduled after receiving the results of all assigned tests. You will receive two versions of the test list: a minimal and a maximal one.
Patients who, despite filling out the questionnaire, decide not to perform the assigned tests, shall be signed in to the reserve list. The patients who performed the assigned tests (at least the minimum list) shall be prioritized for appointments. The reserve list does not guarantee availability of appointments or receiving a consultation.

3. Patients having a large amount of biomedical test results not ordered by our clinic, may utilize our test assignment service. However, the condition for receiving a consultation is performing the test assigned by dr Cubala. We do not offer an interpretation of tests performed outside of our clinic, these tests are only taken into consideration during a consultation and during test assignment.

4. An answer, along with the assigned tests, shall be provided within 14 business days (excluding bank holidays, holiday season and days the Arcana clinic is closed). The reply shall be sent to the email address provided in the questionnaire. When replying to it, please state if you wish to perform the assigned tests – if so, the necessary kits and instructions shall be sent to you within 3-4 business days. After receiving all of the results, the appointment is made for the nearest possible date. The date shall be sent to you via email.

II. Questionnaire

Basic information:
1. Filling out personal details of the child and the parents or legal guardians, as well as the consent form on the last page are required – we cannot provide you with the service without them.
2. Questionnaire should be filled as a file on a computer, by filling out the provided spaces (on underscores – they will disappear automatically). We ask that you do not fill out the documents by hand (with the exception of the last page).
1. Please fill out, in the space provided, all the tests that offered results deviating from the norm. Additionally, at the end of the questionnaire, please provide any diseases that have already been ruled out. Please bring the rest of the test results to the first appointment. We ask that you do not send any results that fall within the normal boundaries.
2. We ask that the sent biomedical results be no more than one year old. Please provide other lab results (including biomedical ones) in the space provided, listing only the date and a short description regarding the results and treatment.
3. At the end of the questionnaire, in the space provided, please enter any possible other tests which you are considering or awaiting results. We also ask that, in the time between filling out the questionnaire and the appointment, to not undergo any tests other than prescribed by dr Cubala.

III. Registration procedure

Before beginning, we ask that you familiarize yourself with the Regulations regarding detailed instructions for filling out the questionnaire (section 1 of the Regulations).
1. In order to begin the process, please download and fill out the questionnaire, according to Regulations – click here to download the questionnaire
2. Please email the following information to with the subject “Test assignment” or child’s full name:
– Questionnaire, properly filled out in Microsoft Word on a PC (with the exception of the last page, which should be filled out by hand)
– Consent form for the tests filled out and signed
– Optionally: lab test results – only those differing from reference values (as a PDF file)
– Bank transfer confirmation, in the amount of 200 PLN (as a PDF or JPEG file)
3. Please send signed master copy of the consent for by a registered letter or bring it personally to: Arcana IMI, Kniaziewicza 45/10, 05-500 Piaseczno. The master copy must be received within 14 business days of sending the form.
Please do not send a printed questionnaire or test results – only the signed consent page.
The date of registration is considered as the day of emailing all required documents:
– filled out questionnaire, scanned consent form and bank transfer confirmation.

2. Types of consultations

We offer the following consultations:
– Initial consultation (anamnesis, reviewing previous paperwork, patient evaluation, deciding the recommendations):
– Autistic children (diagnosed, suspected or showing symptoms) – for the first visit regarding a child, we always reserve 50 minutes*
– Non-autistic children – for children with other diseases, we reserve 30 minutes*
– Adults – for adults we reserve 30 minutes
– Follow-up consultation (evaluating the treatment progress, consecutive consultations): 30 minutes*
– Follow-up consultation with reviewing some of the test results assigned by dr Cubala-Kucharska or regarding more than one patient: 50 min*
– Emergency consultation – a few-minute phone call in case of a sudden and acute deterioration of patient’s health.
*In the case of treating more than one person, the time is decided on a per-case basis.
The payment is done for the allotted time. There is no possibility of extending it during a consultation, since that would cause delays to other patients.
Having the interest of other patients in mind, we sincerely ask you not to be late and not to prolong the consultations. We also ask that you arrive no later than 5-10 minutes before the scheduled appointment.
Appointments are considered valid only after being confirmed by us during the week leading to the appointment.

I. Follow-up consultations

Dates: Follow-up consultations (all consultations following the first one) are decided for a particular month and not the day.* Circa one month before we shall contact you in order to decide on the exact date of the appointment. In case of doubts, by the end of your appointment time, please ask the doctor when it is suggested you visit again.
* The rule pertains to appointments from June 2017 onwards. It does not pertain to previously scheduled appointments.
Preparation: for a follow-up consultation, patients/parents are required to provide:
1. Report on the patient’s current condition
2. A tallied ATEC test (only for children with autism)
Document drafts are available on our website and are also emailed to you before each scheduled visit. A well filled out report is useful both for the parents and the doctor, by sorting the important data regarding therapy, and therefore streamlining the appointment itself. Proper forms are available per request at the office. Proper preparation before the consultation (questions, doubts) will allow for a better use of allotted time. Considering the sophistication of the treatment, we suggest taking notes during appointments and consultation.
We sincerely ask you to prepare beforehand (send new test results, prepare questions, write down used medicines and supplements, and medicines requiring a renewed prescription). It will streamline the consultation and allow you to utilize the allotted time more fully.
The doctor may refuse seeing unprepared patients.

II. Follow-up Skype/phone consultation

For people living far from us, after having your first consultation at the clinic, follow-up ones may be done via phone or Skype.
Skype consultation, in justified circumstances, may precede start of the treatment at the clinic. In this case, the second visit must be done in person. Please bear in mind that phone consultations are treated as an exception and not a rule. It is suggested to visit in person at least once a year. Phone consultation should otherwise be treated like a normal visit in person, requiring active patient participation and cooperation with the doctor.
Remote consultation entails:
– time required for the doctor to parse the documentation – ca. 10 minutes,
– call: 30 minutes, in case of a follow-up: 15-20 minutes,
– preparing recommendations and prescriptions: ca. 5-10 minutes,
– time used by the front desk (preparing documents to be sent after the consultation).
– consultation take place only during office hours and after a previous reservation and payment.
We sincerely ask you to prepare beforehand (send new test results, prepare questions, write down used medicines and supplements, and medicines requiring a renewed prescription). It will streamline the consultation and allow you to utilize the allotted time more fully.

III. Urgent Skype/phone consultation

In the case of a sudden illness or appearance of new acute adverse effects during treatment, or in the case of urgent need for consultation regarding allotted treatment, an urgent consultation needs to be scheduled. Such consultations are scheduled during office hours. A request for this consultation should be placed at the clinic, preferably by email, along with a short description of the situation. The consultation is then scheduled for the nearest available day, however, there is no possibility of determining the exact time (at most, a time frame can be offered).
Such consultation are only available to active patients – they are not available to patients who have not contacted the clinic for more than 6 months.
Preparation for an urgent consultation entails writing:
– a list of medicines and supplement being taken,
– a note regarding the problem.
Prescriptions and recommendations can also be written out during this consultation if needed.

3. Canceling a consultation

– We ask that you cancel consultation no later than 3 working days before the visit, which will allow other patients to use the newly-freed time. In the case of canceling a consultation after that date, there will be a surcharge of 70 PLN added to the cost of next consultation. The surcharge is waived in the case of an unexpected situation (e.g. an acute disease).
– The appointment is treated as canceled only after a confirmation by an Arcana employee.
– In the case of canceling several visits or a lack of contact with the patient, we reserve a right not to schedule following visits. All the previous appointments shall also be canceled.

4. Presence of child during visits

The presence of child during the first consultation is mandatory. It is not mandatory for following visits (e.g. discussing the test results).

5. Contacting the clinic between visits

We respond to emails and phone calls during office hours. Contacting the doctor may be limited during dr Cubala’s business trips, therefore the reply time may be longer.
We accept phone calls and emails regarding:
– scheduling visits and consultations,
– questions regarding substitutes of prescribed medicines and supplements that are not available at the time; in the case of questions regarding supplements, please provide the exact composition (written on the packaging) and the trade name.
– shipping times for international packages,
– questions about technical details of assigned tests.
We would like to remind that new tests and issues can only be discussed with the doctor during a consultation.
After receiving your medical recommendations, please make sure if you have any doubts or additional questions as to their content. Giving additional explanations or clearing out potential confusing points is easier, both for us and for you, when it is done after a consultation. It helps avoid an extended wait for an answer.
Any questions regarding the recommendations should be reported no later than the next day. We ask that you sent them in a SINGLE email, with the child’s full name in the subject line.

6. Additional services

– writing out a medical certificate* outside of a consultation – 50 PLN,
– writing out a prescription* between consultations – 80 PLN,
– providing additional clinical pathway at the patient’s request, help with ordering medicines, any other additional front desk work – hourly rate for the additional time,
– test selection – 200 PLN (persons not interested in a medical consultation may also use the test selection service by sending the questionnaire – the procedure is explained in section 1 of the regulations).
* Prescriptions and certificates are given only in cases deemed legitimate by the doctor. Court certificates are only given at the request of the court. We do not give certificates granting exemption from vaccinations.

7. Invoices

Each payment is confirmed by a cash register receipt. We offer invoices only at the express request of the parent. The request for invoice, as well as invoice data (and, if applicable, the address for postal delivery) should be provided to the clinic alongside the bank transfer confirmation (in person or via email). We also offer writing out invoices to a foundation – please include additionally foundation data and, if applicable, the sub account number).

8. Important information

I. Writing prescriptions during a visit
We would like to ask for silence while the prescription is being written out. This request is due to a need for concentration.

9. Dietary consultations

– For each consultation with the dietician, we ask that you prepare a report with the following information:
– child’s current height and weight,
– 3-5 day menu (for consecutive days, if possible), including weekend days,
– any questions for the dietician.
A phone or Skype dietary consultation is possible.
Child’s presence at the consultation is not required. If possible, please do not bring your child, or, alternatively, offer the child company during the appointment.
We ask to write down any questions for the dietician and take labels or Internet links to the products you wish to ask about.
We also ask that you send any questions regarding the recommendations no later than 3 days after receiving them.
The Arcana clinic reserves the right to alter these Regulations.