Formulaire

Notice of Work Stoppage

Cerfa 10170*08

Specimen.

For his approach, the employee uses the form provided by the doctor. Access to the notice n°50069#08.

Please note

Since May 2022, a merger of the various forms used to prescribe work stoppages (illness, occupational disease,, extension, etc.) has been carried out. The reporting and instruction rules remain unchanged. It is always given to the health professional after having informed you.

    Fill out the 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 : Ministry of Health

    Verified 28 April 2026 - Public Service / Directorate of Legal and Administrative Information (Prime Minister)