Formulaire

Accident at work Occupational Disease or Occupational Disease Sheet (Specimen) (Form 11383*02)

Cerfa 11383*02 (S6201c)

Please note that this version is a specimen (supplied) only for your information).

Accident at work For your application, the original form is given to you by the employer in case of a medical treatment or by the CPAM or the MSA when an occupational disease is declared.

    Fill out the form

    For details, please use the practical information sheets :

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

    Verified 08 April 2025 - Directorate for Legal and Administrative Information (Prime Minister)