Guide · MDPH form
The MDPH application form (CERFA 15692*01): its parts and what to fill in
The short answer
The MDPH application form is CERFA 15692*01: 20 pages, six parts from A to F. For a first application, fill in everything that applies to you; for a renewal with no change, parts A and E are enough. Always attach the medical certificate (less than a year old), an ID document and proof of address.
One form for every application
CERFA 15692*01 is used to apply for every right the MDPH handles: the AAH allowance, the PCH compensation benefit, the mobility inclusion card, RQTH status, the AEEH child allowance, referrals, school support… You do not need a separate form for each right. You can find it on Service-Public or at your MDPH’s reception desk. Many MDPHs also let you fill it in online.
The form is only in French, and the MDPH works in French.
The six parts
| Part | Pages | Content | Who fills it in |
|---|---|---|---|
| A | 2 to 4 | Identity, help with the paperwork, legal protection, urgency, signature | Everyone |
| B | 5 to 8 | Daily life, needs, expectations | First application, or a change in your situation |
| C | 9 to 12 | School or student life | Children, students, apprentices |
| D | 13 to 16 | Work situation | If you work, are looking for work, or apply for the AAH |
| E | 17 and 18 | The rights and benefits you ask for | Recommended for everyone |
| F | 19 and 20 | The family carer | Optional, filled in by the carer |
Which parts to fill in
Page 1 of the form explains it (CERFA 15692):
- first application, or your situation has changed: fill in the whole form, to describe all your needs;
- renewal with no change: fill in parts A and E; you may fill in the rest too.
For the AAH, part E asks you to fill in part D as well, because the MDPH also looks at RQTH status and work referral at the same time.
Pages that are easy to miss
- Page 3, fast processing: if your rights end in less than 2 months, if you risk losing your home or job… See the MDPH fast-track.
- Page 4, the simplified procedure: possible for a renewal with no change, but you will not be able to be heard by the committee that decides (CDAPH).
- Page 4, a hard-to-get certificate: a box lets you say your doctor had difficulty filling in the certificate.
- Page 8, free text: the only page where you tell your story in your own words. See part B.
Required documents
According to Mon parcours handicap:
- the medical certificate (CERFA 15695), the original, less than 12 months old;
- a double-sided photocopy of your ID document (or residence permit);
- proof of address;
- if relevant, the court decision on legal protection.
The printed form still mentions a certificate less than 6 months old: the current rule is 12 months. See the medical certificate.
Before sending
- Date and sign page 4 (both parents for a child under 18).
- Keep a copy of the form and the certificate.
- Allow about 4 months for a decision, sometimes more depending on your département.
The full list of documents and the most common mistakes: the MDPH documents checklist.
The French form, filled in from your English answers
DossierMalin asks you the questions one by one in English, with an example under each, then fills in the official French form (parts A to E). You only need to sign.