Ordering a form BL1

I order my BL1 form online

Fields marked with an asterisk (*) are mandatory.

Name*

Firstname*

13-digit identification number*

Address*

Postcode*

Town*

Country *

E-mail address (example: info@public.lu)*

Health fund in the country of residence*

Reason for request*

I request my BL1 form by completing the required fields on the application and clicking PREVIEW. On the summary page, I carefully review the information one final time before confirming by clicking SEND.

Please note! By completing this form, I agree to my personal data being processed for the purposes of my request. I click here for more information on the CNS's data privacy policy.

The rules

I work in Luxembourg and I live in Belgium, so I'm a cross-border worker.

I have an important procedure to carry out in my country of residence: register with a local health insurance fund (mutualité).

To register, I need a certificate that the CNS will send me - form BL1!

If I have not received it automatically within 15 days of receiving the declaration of entry from the Joint Social Security Centre (CCSS), I can order the BL1 form on this page.

The BL1 form, issued by the CNS, allows me to register with a health insurance fund in my country of residence. This entitles me to receive treatment and reimbursement in my country of residence.

I can obtain further information on the CROSS-BORDER WORKERS page

Last update 02.01.2025