Formulaire

Application to the guardianship judge - Reconsideration of a judicial protection measure of an adult

Cerfa 14919*05

  • Person wishing to do edit or renew a judicial protection measure (safeguarding of justice, guardianship, guardianship, family empowerment) or obtain its authorization release
  • Free for the filing of the request, €192 TTC for the issue of the medical certificate
  • 5 steps
  • Before the expiry of the time limit set out in the judgment initiating the measure

Fill out the form

To whom shall I send this form ?

Comment faire ?

  1. Have the detailed medical certificate
  2. Print the form
  3. Fill the form
  4. Date and sign the form
  5. Submit the completed form and the documents to be attached to the guardianship judge : sending by post or depositing at the reception of the court of justice or near the place of residence of the adult to be protected or the guardian's home

  • Detailed medical certificate : it is established by a licensed physician if you request the renewal of a family authorization or the increase of a measure, or by the attending physician of the middle finger in other cases
  • Full copy of the birth certificate of the person to be protected, less than 3 months old
  • Copy (double-sided) of the identity document of the person to be protected
  • Copy (double-sided) of your ID

Notice n°51708#05 presents the approach and explains how to complete the form.

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Verified 12 June 2026 - Public Service / (Prime Minister)