Formulaire

Claim for compensation from Oniam (damage related to a mandatory vaccination)

  • Person concerned by one harm following a compulsory vaccination
  • Free in the event of deposit of the file on-site. Otherwise, cost of a registered letter with acknowledgement of receipt.
  • 5 steps
  • Language French

Fill out the form

To whom shall I send this form ?

Comment faire ?

  1. Fill the online form
  2. Download the form
  3. Print it
  4. The sign
  5. Send it atOniam: titleContent (transfused and hemophiliacs department)

They vary depending on your situation:

Répondez aux questions successives et les réponses s’afficheront automatiquement

General case

  • Original form completed and signed
  • Copy of any document attesting to your identity (identity card, residence card...)
  • Copy of any document, bearing your first and last names, specifying the date(s) of injection(s) of the vaccination(s) involved (e.g.: health record, vaccination record, medical certificate, etc.)
  • Copy of any document attesting to the mandatory nature of the vaccination or vaccinations involved (examples: attestation from your employer specifying your function, the date of your hiring and if applicable the date on which you left the establishment or copy(s) of the salary slips corresponding to the dates of injections)
  • Copy of medical documents attesting to the date of appearance of the 1ers symptoms of the condition you attribute to vaccination
  • Copy of the entire medical record since the date of 1era medical consultation until the day of referral to theOniam: titleContent, otherwise, a copy of a recent medical certificate describing the evolution of the disease attributed to vaccination
  • Copy of your entire medical file with your attending physician including notes and / or reports of consultations tracing your personal history
  • Copy of the pharmacovigilance declaration made by you or by a healthcare professional and the response provided by the pharmacovigilance center
  • Any evidence to assess the nature and extent of the damage suffered

You're not the direct victim

  • Original form completed and signed
  • Copy of any document attesting to your identity (identity card, residence card...)
  • Copy of any document, bearing your first and last names, specifying the date(s) of injection(s) of the vaccination(s) involved (e.g.: health record, vaccination record, medical certificate, etc.)
  • Copy of any document attesting to the mandatory nature of the vaccination or vaccinations involved (examples: attestation from your employer specifying your function, the date of your hiring and if applicable the date on which you left the establishment or copy(s) of the salary slips corresponding to the dates of injections)
  • Copy of medical documents attesting to the date of appearance of the 1ers symptoms of the condition you attribute to vaccination
  • Copy of the entire medical record since the date of 1era medical consultation until the day of referral to theOniam: titleContent, otherwise, a copy of a recent medical certificate describing the evolution of the disease attributed to vaccination
  • Copy of your entire medical file with your attending physician including notes and / or reports of consultations tracing your personal history
  • Copy of the pharmacovigilance declaration made by you or by a healthcare professional and the response provided by the pharmacovigilance center
  • Any evidence to assess the nature and extent of the damage suffered
  • Copy of any document establishing your relationship with the victim and allowing you to assess your harm

You are entitled to a deceased person

  • Original form completed and signed
  • Copy of any document attesting to your identity (identity card, residence card...)
  • Copy of any document, bearing your first and last names, specifying the date(s) of injection(s) of the vaccination(s) involved (e.g.: health record, vaccination record, medical certificate, etc.)
  • Copy of any document attesting to the mandatory nature of the vaccination or vaccinations involved (examples: attestation from your employer specifying your function, the date of your hiring and if applicable the date on which you left the establishment or copy(s) of the salary slips corresponding to the dates of injections)
  • Copy of medical documents attesting to the date of appearance of the 1ers symptoms of the condition you attribute to vaccination
  • Copy of the entire medical record since the date of 1era medical consultation until the day of referral to theOniam: titleContent, otherwise, a copy of a recent medical certificate describing the evolution of the disease attributed to vaccination
  • Copy of your entire medical file with your attending physician including notes and / or reports of consultations tracing your personal history
  • Copy of the pharmacovigilance declaration made by you or by a healthcare professional and the response provided by the pharmacovigilance center
  • Any evidence to assess the nature and extent of the damage suffered
  • Copy of the victim's death certificate as well as a copy of any document proving your links with the deceased person (examples: deed of notoriety, family record book, birth certificate)

You are a legal representative

  • Original form completed and signed
  • Copy of any document attesting to your identity (identity card, residence card...)
  • Copy of any document, bearing your first and last names, specifying the date(s) of injection(s) of the vaccination(s) involved (e.g.: health record, vaccination record, medical certificate, etc.)
  • Copy of any document attesting to the mandatory nature of the vaccination or vaccinations involved (examples: attestation from your employer specifying your function, the date of your hiring and if applicable the date on which you left the establishment or copy(s) of the salary slips corresponding to the dates of injections)
  • Copy of medical documents attesting to the date of appearance of the 1ers symptoms of the condition you attribute to vaccination
  • Copy of the entire medical record since the date of 1era medical consultation until the day of referral to theOniam: titleContent, otherwise, a copy of a recent medical certificate describing the evolution of the disease attributed to vaccination
  • Copy of your entire medical file with your attending physician including notes and / or reports of consultations tracing your personal history
  • Copy of the pharmacovigilance declaration made by you or by a healthcare professional and the response provided by the pharmacovigilance center
  • Any evidence to assess the nature and extent of the damage suffered
  • Copy of any document proving that you are a legal representative (examples: family record book, guardianship judgment)

One package leaflet outlines the process to be followed.

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Verified 23 April 2026 - Public Service / Directorate of Legal and Administrative Information (Prime Minister)