This Mental Health Act certificate extends a Yukon patient's involuntary admission beyond the current certificate. Shortly before a Form 7 certificate or an earlier renewal expires, the attending physician and one other physician each examine the patient and complete a separate copy, recording the original admission date and facility, current findings, a diagnosis and the grounds for continued involuntary care.
The attending physician and one other physician each complete and sign a separate copy of the whole form, with a witness signature. Nothing on the certificate is completed by the patient.
Download the current version from the source each time; forms change without notice.
Form 11 - Certificate of Renewal of Involuntary Admission
Formulaire 11 - Certificat de renouvellement d'admission non volontaire
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Section 16 of the Mental Health Act requires the examination shortly before a certificate of involuntary admission or its renewal expires. An involuntary patient whose authorized period has expired is deemed a voluntary patient under section 17, so the renewal has to be completed and filed before the current period ends.
Each certificate of renewal authorizes detention, observation and examination in hospital for not more than 21 days, under section 16(2) of the Act. A further renewal follows the same process: a new examination by the attending physician and one other physician, and two new copies of Form 11.
Yes. Yukon posts Formulaire 11, Certificat de renouvellement d'admission non volontaire, on its French forms page. Both versions are three-page fillable PDFs; the English edition is dated July 2019 and the French edition September 2019.