Formulaire

Second Health Certificate (Form 12597*06)

Cerfa 12597*06

It must be completed during the mandatory preventive examination on 9e month. The family completes the administrative part before the consultation and hands it over to the doctor.

The doctor 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)