Care Record - Care Received Abroad by Posted Employee (Form 11790*01)

National Health Insurance Fund (Cnam) - Cerfa n° 11790*01
Autre numéro : S3124a

Relates to an employee posted to a country outside Europe.

Must be accompanied by originals of invoices paid by the insured and medical prescriptions.

Go to the online administrative form

Verified 15 February 2021 - Directorate for Legal and Administrative Information (Prime Minister)

To whom shall I send this form ?

For details, please use the practical information sheets :

J'ai réalisé une démarche administrative

Je donne mon avis sur Services Publics +. L'administration concernée me répondra.