Forms

Forms


Document titleLanguage
Claiming compensation for damage caused by vaccination
 fr.pdf(968 KB)
Medical control service - request for an accompanying person
 fr.pdf(51 KB)
 de.pdf(51 KB)
 en.pdf(51 KB)
 pt.pdf(51 KB)
Application for long-term care insurance benefits
 fr.pdf(891 KB)
 de.pdf(856 KB)
Application form for obtaining additional reimbursement in the circumstances set out in paragraph art. 154bis
 fr.pdf(223 KB)
Mandate to appoint a person of trust
 fr.pdf(49 KB)
Patient's request for voluntary active euthanasia or physician-assisted suicide
 fr.pdf(1022 KB)
 de.pdf(1.03 MB)
 en.pdf(1.02 MB)
FNS - Application for the supplement - Form for the applicant
 fr.pdf(596 KB)
 de.pdf(445 KB)
FNS - Application for the supplement - Form for the spouse/partner
 fr.pdf(363 KB)
 de.pdf(406 KB)



Forms to request a copy of your patient file


Document titleLanguage
CHdN - form to request a copy of your patient file
 fr.pdf(315 KB)
CHEM - form to request a copy of your patient file
 fr.pdf(67 KB)
Form to request a copy of your patient file
 fr.pdf(216 KB)
HIS - Formulaire de demande dossier patient
HRS - form to request a copy of a deceased patient file
 fr.pdf(89 KB)
HRS - form to request a copy of your patient file
 fr.pdf(222 KB)
Request for my patient file from a private practice
 fr.pdf(31 KB)