The attending psychiatrist uses this certificate under section 11 of PEI's Mental Health Act to continue a patient's involuntary admission. It follows a new psychiatric assessment within the previous 72 hours. The renewal period depends on how many renewals came before: 30 days for the first, 90 days for the second or third, and 12 months for the fourth and later ones.
The attending psychiatrist completes and signs the whole certificate, recording the assessment times, the three opinions, the facts and observations behind them, information from other sources, and which renewal this is.
Download the current version from the source each time; forms change without notice.
Form 4 - Certificate of Renewal of Involuntary Admission
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
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A first certificate of renewal expires 30 days from the date it is issued. A second or third renewal lasts 90 days, and a fourth or later renewal lasts 12 months. Any certificate can be cancelled sooner by the attending psychiatrist.
The attending psychiatrist must have personally conducted a psychiatric assessment of the patient within the previous 72 hours, at the psychiatric facility, and record when it started and ended. The certificate also asks for the facts and personal observations behind the opinion, kept apart from information from other sources.