Address of stay during a sick leave

This form allows the insured person to inform the CNS of an address of stay other than their legal address of residence.

An insured person is required to inform the CNS of their address of stay during an incapacity for work, if this address differs from the legal address of residence. Generally, the address of stay must be stated on the certificate of incapacity for work.

If the insured person has not provided the address of stay on the certificate of incapacity for work, they must inform the CNS for instance by using the form below.

IMPORTANT: Prior authorisation from the CNS is required for any stay during an incapacity for work in a country other than the one in which the insured person officially resides.

Authorisation for a stay abroad during an incapacity for work can only be granted in a limited number of situations.

This form cannot be used to apply for a stay abroad.

Fields marked with an asterisk (*) are mandatory.

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Personal Data Protection

To complete your application, the information about you collected from this form needs to be processed by the public administration concerned.

That information is kept by the administration in question for as long as it is required to achieve the purpose of the processing operation(s).

Your data will be shared with other public administrations that are necessary for the processing of your application. For details on which departments will have access to the data on this form, please contact the public administration you are filing your application with.

Under the terms of Regulation (EU) 2016/679 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, you have the right to access, rectify or, where applicable, remove any information relating to you. You are also entitled to withdraw your consent at any time.

Additionally, unless the processing of your personal data is compulsory, you may, with legitimate reasons, oppose the processing of such data.

If you wish to exercise these rights and/or obtain a record of the information held about you, please contact the administration in question using the contact details provided on the form. You are also entitled to file a claim with the National Commission for Data Protection (Commission nationale pour la protection des données), headquartered at 1, Avenue du Rock'n'Roll, L-4361 Esch-sur-Alzette.

By submitting your application, you agree that your personal data may be processed as part of the application process.

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