Formulaire

Request for prior agreement for long-term respiratory assistance treatment at home

Form template posted online for information

For your approach, you must use the original form provided by the healthcare professional.

    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 : National Health Insurance Fund (Cnam)

    Verified 04 November 2026 - Public Service / (Prime Minister)