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BC Form 4.2: Second Medical Certificate (Mental Health)

Within 48 hours of an involuntary admission on a Form 4.1, a second physician examines the patient and completes this certificate if the four admission criteria are still met. Once the MHA director or delegate signs Section 2, involuntary admission continues for up to one month from the admission date. Keeping the patient beyond that month requires a renewal certificate, Form 6.

Who completes it

A physician completes Section 1, giving reasons for the same four opinions as Form 4.1, and signs with the date, 24-hour time, phone number and college ID. Section 22 of the Act requires a physician other than the one who completed the first certificate; the MHA director or delegate completes Section 2.

Submitting and payment

How to submit it
The form stays at the designated facility: the director or delegate completes Section 2 Part A for ordinary admissions, or Part B for admissions under section 29(5), and the patient is given a copy. The Guide says original certificates are filed at the admitting facility.
Who pays
MSP fee item 00065 covers an investigation with completion of BC Mental Health Act Forms 3, 4.1, 4.2 or 6 (per doctor), and 00066 covers completion on a previously assessed or treated case.

Good to know

  • Section 22 of the Act requires Form 4.2 within the 48-hour period following the time of admission; otherwise the Guide says the patient must be discharged or admitted as a voluntary patient.
  • The one-month period runs from the admission date, and the Guide counts a month as the corresponding day of the next month less a day: an admission on March 15 ends at midnight April 14.
  • For a person in a correctional centre or youth custody centre (section 29), Section 1 names that centre; on admission under section 29(5), the director completes Part B after reviewing both certificates.
  • The form's note says rights advice must be repeated at each renewal and documented on Form 13, and that extension beyond one month needs a new assessment and Form 6 before the month lapses.

Get the official form

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Form 4.2 - Second Medical Certificate (Involuntary Admission)

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Frequently asked questions

Who can sign BC Form 4.2?

Only a physician. Section 22(2.1) of the Mental Health Act requires the second medical certificate to be completed by a physician other than the physician who completed the first certificate. Unlike Form 4.1, the form has no nurse practitioner option; its signature block asks for the examining physician's name, college ID, phone number, and the date and 24-hour time signed.

When must Form 4.2 be completed?

Within 48 hours after the time of admission, which begins when the director or delegate completes Section 2 of the Form 4.1. The Guide says the second certificate should be done as soon as practical while allowing a thorough examination and collateral information, and that two certificates should normally be in place before treatment starts.

How long does involuntary admission last after Form 4.2?

Up to one month from the date of the initial admission. To continue past that, a physician must examine the patient and complete a Form 6 renewal certificate before the month lapses. Under section 24 of the Act, renewals then run for one month, three months and successive six-month periods.