Application for approval of an association of users of the health system - Form A (Form 12623*02)

Ministry of Health - Cerfa n° 12623*02

Allows an association or union of associations to apply for national or regional approval for its action in the field of quality of care and patient care.

Does not allow for the renewal of a license.

For associations, this application must be supplemented by a form B for each association affiliated to the union.

Go to the online administrative form

Verified 20 December 2023 - Directorate for Legal and Administrative Information (Prime Minister)

To whom shall I send this 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.