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New forms for application for exemption from patient contribution and disability application
Wednesday, 5 August 2015These forms are also available from the page "Healthcare professional", "Forms and documents" section.
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Healthcare professional
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Online services
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Electronic Treatment Form (ETF)
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Forms and documents
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Application for exemption from patient contribution
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Specific application for exemption from patient contribution (affection 22, 24 or 27)
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Disability application
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Request to take charge of spa treatment
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Conventional rate on 1st October 2022 - Self employed Nurses
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Conventional rate on 1st October 2022 - Speech Therapists
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Conventional rate on 1st October 2022 - Physiotherapists
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Conventional rate on 1st April 2023 - Doctors
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Tarification conventionnelle au 1er octobre 2023 - Médecins
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Conventional rate on 1st October 2023 - Self employed Nurses
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Conventional rate on 1st October 2023 - Speech Therapists
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Conventional rate on 1st October 2023 - Physiotherapists
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Application for exemption from patient contribution