Formulaire

Application or renewal of disability benefits (AEEH, AAH, PCH, CMI, accommodation, Ésat...)

Cerfa 15692*01

This form allows you to apply for or renew various benefits (AEEH, AAH, PCH, CMI, accommodation, admission to the State...) from the departmental house of disabled people (MDPH).

The form is only available in French.

The process is free.

FYI  

Individuals wishing to file an application with MDPH of the Aveyron (12), the Corsica (2A–2B), Indre (36), of North (59) or Guyana (973) may, if they so wish, voluntarily participate in an experiment involving the use of a new simplified rights application form (15692*2), or a new identical rights renewal application form. These forms can be filed until June 13, 2026. The concerned MDPHs may distribute them directly on site until May 29, 2026.

You must accompany this form with the following supporting documents:

  • Medical certificate less than 1 year
  • Photocopy on both sides of a proof of identity (valid identity document or residence permit or any other document authorizing residence in France)
  • Photocopy of a proof of residence (for persons hosted by a third party: proof of residence and certificate on the honor of the host)
  • Certificate of judgment in legal protection if you are under legal protection.

Other supporting documents may be requested depending on your request. The nature of the supporting documents shall be specified on the form.

All documents (form and supporting documents) must be sent to the MDPH of your place of residence, preferably by registered letter with acknowledgement of receipt.

The response to your request will take place within 4 months. If you do not receive a response after 4 months, your request is considered rejected.

    Fill out the form

    To whom shall I send this form ?

    Download Medical certificate to attach to an application at the departmental house of disabled people (MDPH)

    OBLIGATOIRE - To be attached to any request. It must be no more than 1 year old. : 

    PDF - 446.2 KB

    Formulaire annexe

    Download Standard report for a hearing assessment to be attached to the medical certificate (part 1)

    FACULTATIF

    PDF - 374.8 KB

    Formulaire annexe

    Download Standard report for an ophthalmological assessment to be attached to the medical certificate (part 2)

    FACULTATIF

    PDF - 1016.4 KB

    Formulaire annexe

    For details, please use the practical information sheets :

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    Émetteur du formulaire administratif : Ministry of Social Affairs

    Verified 03 April 2026 - Public Service / Directorate of Legal and Administrative Information (Prime Minister)