Formulaire

Third health certificate (Form 12598*06)

Cerfa 12598*06

To be completed during the mandatory preventive examination on 24e month of the child.

The family completes the administrative part before the consultation. She hands this certificate over to the doctor who fills out the medical part, stamps it and signs the document.

The doctor sends the health certificate within 8 days to the doctor in charge of the Maternal and Child Protection department of the department.

    Fill out the form

    For details, please use the practical information sheets :

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    Émetteur du formulaire administratif : Ministry of Health

    Verified 01 January 2025 - Directorate for Legal and Administrative Information (Prime Minister)