Request for specific information in the event of a power failure (Form 10401*02)

Ministry of Health - Cerfa n° 10401*02

Allows you to request access to a specific information service for high-risk patients treated at home in the event of a planned or unexpected power outage.

Contains cerfa No. 50184#02 package leaflet.

Go to the online administrative form

Verified 17 March 2023 - Directorate for Legal and Administrative Information (Prime Minister)

To whom shall I send this form ?

J'ai réalisé une démarche administrative

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