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Get Feuille Accident Du Travail Cerfa 11383
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How to fill out the feuille accident du travail cerfa 11383 online
The feuille accident du travail cerfa 11383 is an important document for individuals who have experienced a work-related accident or occupational disease. This guide will provide you with clear, step-by-step instructions on how to correctly fill out this form online, ensuring that you understand each section and its purpose.
Follow the steps to accurately complete the form.
- Click 'Get Form' button to obtain the form and open it in the online editor.
- Begin filling out the victim's identification information. Include the full name (including any preferred name), address, postal code, identification number, and date of birth.
- Next, provide the employer's identification details. This includes the name or business name, address, postal code, and the SIRET number of the establishment.
- Indicate whether the employer is authorized to manage occupational accident risks by selecting 'yes' or 'no'.
- Describe the nature of the incident by marking 'accident du travail' or 'maladie professionnelle'. Include the date of the incident and any subsequent medical evaluations.
- Document any injuries by specifying the nature and location of the lesions sustained during the accident.
- If applicable, fill out the renewal request section at the bottom of the form, indicating your address and the date when requesting a renewal of the feuille.
- Finally, review all the entered information for accuracy. Once completed, save the changes, then download, print, or share the completed form as required.
Start completing your feuille accident du travail cerfa 11383 online today.
Pour récupérer une feuille de soins, vous devez consulter votre médecin qui vous la délivrera lors de votre rendez-vous. Cette feuille est nécessaire pour le remboursement de vos frais médicaux. En cas de perte, vous pouvez également demander une nouvelle copie à votre médecin ou l'établissement de santé concerné.