Application for payment of personal health costs in the event of sickness or maternity (Form 15680*01)

National Health Insurance Fund (Cnam) - Cerfa n° 15680*01
Autre numéro : S1110

To be used if you were attached to a social security policyholder and apply to become insured. To do this, you must be at least 16 years old.

Go to the online administrative form

Verified 03 May 2019 - 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

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