Mental Health and Substance Use Forms

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Forms for Addiction Information Management System, Client/Patient Information Management and Mental Health Act Forms.

AIMS (Addiction Information Management System)

CPIM (Client/Patient Information Management)

Secure Room Standards

Mental Health Act Forms

• Form 1: Option 1: Request for Admission (Voluntary Patients) (Fill and Print PDF, 496KB)
• Form 1: Option 2: Request for Admission (Voluntary Patients) (Print PDF, 33KB)

• Form 2: Option 1: Consent for Treatment (Voluntary Patient) (Fill and Print PDF, 492KB)
• Form 2: Option 2: Consent for Treatment (Voluntary Patient) (Print PDF, 37KB)

• Form 3: Option 1: Medical Report (Examination of a Person Under 16 Years of Age, Admitted at the Request of Parent or Guardian) (Renewal Certificate) (Fill and Print PDF, 492KB)
• Form 3: Option 2: Medical Report (Examination of a Person Under 16 Years of Age, Admitted at the Request of Parent or Guardian) (Renewal Certificate) (Print PDF, 45KB)

• Form 4.1: First Medical Certificate (Involuntary Admission) (Fill and Print PDF, 958KB)
• Form 4.2: Second Medical Certificate (Involuntary Admission) (Fill and Print PDF, 958KB)

• Form 5: Option 1: Consent for Treatment (Involuntary Patient) (Fill and Print PDF, 496KB)
• Form 5: Option 2: Consent for Treatment (Involuntary Patient) (Print PDF, 40KB)

• Form 6: Option 1: Medical Report on Examination of Involuntary Patient (Renewal Certificate) (Fill and Print PDF, 492KB)
• Form 6: Option 2: Medical Report on Examination of Involuntary Patient (Renewal Certificate) (Print PDF, 50KB)

• Form 7: Option 1: Application for Review Panel Hearing (Fill and Print PDF, 487KB)
• Form 7: Option 2: Application for Review Panel Hearing (Print PDF, 36KB)

• Form 8: Option 1: Review Panel Determination (Fill and Print PDF, 492KB)
• Form 8: Option 2: Review Panel Determination (Print PDF, 39KB)

• Form 9: Option 1: Application for Warrant (Apprehension of Person with Apparent Mental Disorder for Purpose of Examination) (Fill and Print PDF, 504KB)
• Form 9: Option 2: Application for Warrant (Apprehension of Person with Apparent Mental Disorder for Purpose of Examination) (Print PDF, 59KB)

• Form 10: Option 1: Warrant (Apprehension of Person with Apparent Mental Disorder) (Fill and Print PDF, 586KB)
• Form 10: Option 2: Warrant (Apprehension of Person with Apparent Mental Disorder) (Print PDF, 38KB)

• Form 11: Option 1: Request for Second Medical Opinion (Fill and Print PDF, 496KB)
• Form 11: Option 2: Request for Second Medical Opinion (Print PDF, 40KB)

• Form 12: Option 1: Medical Report (Second Medical Opinion) (Fill and Print PDF, 492KB)
• Form 12: Option 2: Medical Report (Second Medical Opinion) (Print PDF, 38KB)

• Form 13: Option 1: Notification to Involuntary Patient of Rights Under the Mental Health Act (Fill and Print PDF, 508KB)
• Form 13: Option 2: Notification to Involuntary Patient of Rights Under the Mental Health Act (Print PDF, 60KB)

• Form 14: Option 1: Notification of Patient Under 16, Admitted by a Parent or Guardian, of Rights Under the Mental Health Act (Fill and Print PDF, 508KB)
• Form 14: Option 2: Notification of Patient Under 16, Admitted by a Parent or Guardian, of Rights Under the Mental Health Act (Print PDF, 58KB)

• Form 15: Option 1: Nomination of Near Relative (Fill and Print PDF, 508KB)
• Form 15: Option 2: Nomination of Near Relative (Print PDF, 47KB)

• Form 16: Option 1: Notification to Near Relative (Admission of Involuntary Patient or Patient Under Age 16) (Fill and Print PDF, 512KB)
• Form 16: Option 2: Notification to Near Relative (Admission of Involuntary Patient or Patient Under Age 16) (Print PDF, 77KB)

• Form 17: Option 1: Notification to Near Relative (Discharge of Involuntary Patient) (Fill and Print PDF, 496KB)
• Form 17: Option 2: Notification to Near Relative (Discharge of Involuntary Patient) (Print PDF, 47KB)

• Form 18: Option 1: Notification to Near Relative (Request for a Review Panel Hearing) (Fill and Print PDF, 496KB)
• Form 18: Option 2: Notification to Near Relative (Request for a Review Panel Hearing) (Print PDF, 48KB)

• Form 18.1: Option 1: Notification to Near Relative (Order for a Review Panel Hearing) (Fill and Print PDF, 496KB)
• Form 18.1: Option 2: Notification to Near Relative (Order for a Review Panel Hearing) (Print PDF, 50KB)

• Form 19: Option 1: Certificate of Discharge (Fill and Print PDF, 487KB)
• Form 19: Option 2: Certificate of Discharge (Print PDF, 34KB)

• Form 20: Option 1: Leave Authorization (Fill and Print PDF, 496KB)
• Form 20: Option 2: Leave Authorization (Print PDF, 45KB)

• Form 21: Option 1: Director's Warrant (Apprehension of Patient) (Fill and Print PDF, 492KB)
• Form 21: Option 2: Director's Warrant (Apprehension of Patient) (Print PDF, 42KB)

The B.C. Public Service acknowledges the territories of First Nations around B.C. and is grateful to carry out our work on these lands. We acknowledge the rights, interests, priorities, and concerns of all Indigenous Peoples - First Nations, Métis, and Inuit - respecting and acknowledging their distinct cultures, histories, rights, laws, and governments.

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