Paris Marathon Medical Certificate
The Paris Marathon has required a PPS (Pass Prévention Santé) attestation, and a doctor-signed medical certificate was not accepted in its place. The PPS replaced the medical certificate for non-licensed adults across French athletics, and the Semi-Marathon de Paris works the same way. A doctor still has a role: if the PPS health questionnaire flags a risk factor, it will not issue your attestation until you have been assessed. That is where MedicalCert can help, through GMC-registered doctors.
- The PPS is the route for Paris, and this page explains it
- Doctor assessment where the PPS questionnaire refers you to one
- Competitive-sport wording, in English or French, for events that ask for it
- Full refund if a certificate cannot be issued
Recent Paris Marathons required the PPS, not a certificate. 2027 health rules are not yet published.
From £67 · Issued by MedicalCert UK
What the PPS replaced
The FFA (Fédération Française d'Athlétisme) began phasing out the medical certificate in January 2024, and the PPS became mandatory across French athletics from 1 September 2024. It was called the Parcours de Prévention Santé until January 2026 and is now the Pass Prévention Santé. Here is where each option now stands:
| Option | What it involves | Cost | Accepted for Paris? |
|---|---|---|---|
| PPS attestation | Online health course: read articles, watch videos, complete a cardiovascular risk questionnaire. If no risk factors are flagged, a digital attestation is generated automatically. | €5 (valid 1 year) | Yes. This is the required route |
| Traditional medical certificate | Doctor-signed document stating "absence de contre-indication à la pratique du sport en compétition". | From £67 online. GP fees are set by each practice | No. Not a substitute for the PPS. Needed only if the PPS refers you to a doctor, or for other events that still ask for one |
Foreign runners are not exempt. The FFA does not accept foreign licences, including competition licences from federations affiliated to World Athletics. If you are entering from the UK, you complete the PPS like everyone else. The platform is available in English, French, Italian and Spanish.
What if the PPS flags a risk factor?
The PPS health questionnaire screens for cardiovascular and other risk factors: a family history of cardiac events, chest pain during exercise, and certain pre-existing conditions among them. If any are flagged, the system will not generate an attestation automatically and you are directed to consult a doctor. At that point you need a medical opinion before you can finish the PPS. You can:
- See a doctor locally, your own GP or a private practice, obtain clearance, then return to the PPS platform to complete the process
- Have a GMC-registered doctor assess you online through a service such as MedicalCert, and use that assessment to complete the PPS
Either way, the assessment supports your PPS. It does not replace it, and you should not enter a French race expecting to upload a doctor's letter instead of a PPS number.
Certificate wording, where a certificate is still needed
Plenty of French and other European events outside FFA athletics still ask for a doctor-signed certificate. Where one is required, it must state that you present "no contraindications to the practice of competitive sport", or the French "absence de contre-indication à la pratique du sport en compétition". A generic "fit to participate" or "good health" letter is routinely rejected.
When applying through MedicalCert, name your event on the application. The reviewing doctor will use the correct wording. If your event provides a specific certificate template, upload it with your application.
Timeline: when to apply
Your PPS attestation number is uploaded to your entry during registration. The attestation is valid for one year, so it must still be in date on race day.
- 2027 registration: by ballot, open from 8 to 30 September 2026, with results from 1 October 2026. The organiser had not confirmed the 2027 health documents at the time of writing (September 2026)
- PPS validity: one year from issue, so complete it close enough to the race that it has not expired
- If the questionnaire refers you to a doctor: allow two to three weeks before the upload deadline, so there is room for the assessment and any follow-up
Semi-Marathon de Paris and other French events
The Semi-Marathon de Paris (Paris Half Marathon) follows the same rule as the full marathon: the PPS, not a certificate. FFA-affiliated running events generally work this way. Some non-athletics events, and a few road races run outside the FFA framework, still accept or require a doctor-signed certificate. Events to check individually include:
- Semi-Marathon de Paris
- Marathon de Marseille
- Marathon du Médoc
- Paris-Versailles
- Ekiden de Paris
Events outside FFA athletics, including some trail races, cycling sportives and obstacle races, may not accept the PPS and may require a traditional doctor-signed certificate instead. Italian events are stricter again and require in-person testing that cannot be done remotely. Always check your event's own registration page rather than assuming the Paris rule applies.
Paris Marathon HPC: what replaced it
HPC, or Health Prevention Course, is an English name that race guidance has used for the FFA's digital alternative to the medical certificate. It is not an official FFA title: the scheme is the Pass Prévention Santé (PPS), which the FFA calls the Health Prevention Pass in English. Older event guidance, forum posts and blog articles still refer to the HPC, and runners reasonably assume it is a separate requirement. It is not. If your event guidance mentions an HPC, the PPS is what you now complete.
The substance is broadly unchanged: a short online health education course followed by a cardiovascular risk questionnaire, producing a digital attestation if no risk factors are flagged. The visible differences are the branding, the platform, and the fact that the PPS now carries a fee and a stated validity period of one year.
Whichever name your event guidance uses, the route is the same. You complete the FFA's online course and enter the attestation number during registration. A doctor-signed certificate is not an alternative to that step for entrants from outside France. It becomes relevant where the PPS questionnaire flags a risk factor, because medical clearance is then needed before the attestation is issued.
What the Paris Marathon asks for at registration
Document requirements are checked during registration and again in the document upload window before race day. Runners entering from the UK should expect to provide the following.
- A valid PPS attestation number. Entrants from the UK are asked for one even where they already hold a competition licence from a World Athletics affiliated federation.
- A certificate dated inside the validity window. It must not be more than 12 months old on race day, not on the day you upload it. A certificate obtained early in the previous year can expire between upload and the event.
- Identification matching your entry. The name on the certificate should match the name on the race entry exactly, including middle names where you have used them.
The most common causes of rejection are wording that does not mention competitive sport, an expired date, and a mismatch between the name on the certificate and the name on the entry. All three are avoidable if the certificate is obtained with the event named on the application.
Allow a buffer. Organisers set upload deadlines weeks ahead of race day, and if the reviewing doctor needs further information, the process takes longer. Applying two to three weeks before the deadline leaves room for that.
Other French events that follow the same rules
The PPS requirement is set by the FFA rather than by individual organisers, so it repeats across FFA-labelled road races: non-licensed adults need a PPS attestation, and a doctor-signed certificate is not accepted instead. Events outside FFA athletics, such as cycling sportives under FFC rules, set their own requirements and may still ask for a traditional certificate.
If your season includes several events outside FFA athletics that ask for a certificate, one worded for competitive sport will normally serve for all of them within its 12-month window. If your season also takes in a race in Italy, the requirements change substantially under Italy's DM 18/02/1982 standard.
More on sports medical certificates
Frequently asked questions
Is the PPS free?
Not any more. The PPS was free until 15 January 2026, when the FFA introduced a €5 charge and extended validity from three months to one year. Older guides still describe it as free and valid for three months.
Can I use a UK doctor's certificate instead of the PPS?
No. The Paris Marathon and the Semi-Marathon de Paris require a PPS attestation number, and a doctor's certificate is not accepted in its place. A UK doctor's assessment is useful in one situation: if the PPS questionnaire flags a risk factor and refers you to a doctor before it will issue your attestation. For French and European events outside FFA athletics that do still ask for a certificate, a GMC-registered doctor's certificate is generally accepted where the wording is correct.
Do I need an ECG for the Paris Marathon?
No, not for standard entry. The Paris Marathon does not require an ECG for general participants. However, if you are aged 40 or over, some French organisers recommend one. The Marathon des Sables, by contrast, does require a mandatory ECG.
What is the difference between the PPS and the HPC?
They are the same thing. HPC, or Health Prevention Course, is an unofficial English name for the FFA's Parcours de Prévention Santé. In January 2026 the scheme became the Pass Prévention Santé, still abbreviated PPS, which the FFA calls the Health Prevention Pass in English. Older event guidance, forum posts and blog articles referring to an HPC are describing the same requirement, not a separate one.
My entry form mentions a "certificat médical". What does that mean now?
Most likely the page is out of date, or you are looking at guidance written before the PPS became mandatory in September 2024. For FFA-affiliated events the certificate field has been replaced by a PPS attestation number. If an event genuinely still asks for a certificate, an English-language one is normally accepted provided the wording about competitive sport is correct, and a French statement can be included alongside it.
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