Formulaire

Specific aid form for self-employed persons (health and social work) (Form)

Check the "Respite Assistance for the Self-Employed Worker" box and fill out the form with the following documents:

  • Last tax or non-tax notice (for all household members)
  • Medical certificate attesting, for the self-employed person, the obligation to leave his activity for a medical appointment
  • Medical certificate attesting, for the assisted relative
  • RIB personal
  • Supporting documents to shed light on your difficulties.

The application must be sent to the CPAM of the place of habitual residence of the sole trader.

From your ameli.fr account, you can also find more information by clicking on the virtual assistant "ameliBot" (chatbot):

  • in the "Ask your question here" field, type: "request financial assistance"
  • let yourself be guided

    Fill out the form

    To whom shall I send this form ?

    For details, please use the practical information sheets :

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    Verified 27 November 2024 - Directorate for Legal and Administrative Information (Prime Minister)