Formulaire

First health certificate (Form 12596*04)

Ministry of Health - Cerfa n° 12596*04

It must be completed during the mandatory preventive examination within 8 days of birth. The family completes the administrative part of the certificate and the doctor completes the medical part, stamps it and signs it.

The doctor sends the health certificate within 8 days to the doctor in charge of the Maternal and Child Protection department of the department.

    Go to the online administrative form

    For details, please use the practical information sheets :

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    Émetteur du formulaire administratif : Directorate for Legal and Administrative Information

    Verified 01 January 2025 - Directorate for Legal and Administrative Information (Prime Minister)