Formulaire

Oral Treatments - Prior Agreement Request - Physician (Computer Filling)

Cerfa 10524*01 (S3157)

Form to send to the dental check-up of your health insurance organization.

The form contains recommendations for use.

    Fill out the form

    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.

    Je donne mon avis

    Émetteur du formulaire administratif : National Health Insurance Fund (Cnam)

    Verified 04 November 2026 - Public Service / (Prime Minister)