Forms
Forms
| Document title | Language |
| Claiming compensation for damage caused by vaccination
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| Les tarifs médicaux – infirmiers (version du 01/12/2024)
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| Medical control service - request for an accompanying person
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| Application for long-term care insurance benefits
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| Application form for obtaining additional reimbursement in the circumstances set out in paragraph art. 154bis
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| Mandate to appoint a person of trust
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| Patient's request for voluntary active euthanasia or physician-assisted suicide
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| FNS - Application for the supplement - Form for the applicant
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| FNS - Application for the supplement - Form for the spouse/partner
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Forms to request a copy of your patient file
| Document title | Language |
| CHdN - form to request a copy of your patient file
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| CHEM - form to request a copy of your patient file
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| Form to request a copy of your patient file
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| HIS - Formulaire de demande dossier patient
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| HRS - form to request a copy of a deceased patient file
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| HRS - form to request a copy of your patient file
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| Rehazenter
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| Request for my patient file from a private practice
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fr.pdf (968 KiB)