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SK Form A: Psychiatric Examination Certificate

A physician who examines someone with an apparent mental disorder who refuses a psychiatric examination completes this certificate under section 18 of The Mental Health Services Act. After the physician arranges an examination with a doctor who has admitting privileges to a mental health centre, the certificate lets anyone apprehend and convey the person there, where the examination for Form G must happen within 24 hours of arrival.

Who completes it

The examining physician completes the whole certificate and signs it in front of a witness. If no physician is available within a reasonable period, a prescribed health professional, meaning a supervised resident in psychiatry or a qualifying rural registered or psychiatric nurse, may issue it.

Submitting and payment

How to submit it
The original goes with the person doing the conveying, for the examining physician at the mental health centre, and the examiner keeps a copy. The form's distribution line lists the physician with admitting privileges and the official representative.

Good to know

  • Section 18(5) bars conveying anyone more than seven days after the date of the examination, counted from the examination itself, not from when the certificate was written.
  • The certificate must name the physician with admitting privileges who agreed to examine the person as an out-patient; section 18(2) requires those arrangements before anyone is conveyed.
  • Only one Form A is needed, and none is required when a physician with admitting privileges examines the person directly and can issue the first Form G.
  • The Act requires the examiner to have personally examined the person and made due inquiry into the facts, so collateral information from family, records or police can support the grounds.

Get the official form

Download the current version from the source each time; forms change without notice.

Form A - Certificate of Physician or Prescribed Health Professional that Psychiatric Examination is Required

Official pagePDF

Fill it with Vero

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Can a nurse issue a Saskatchewan Form A?

Only as a prescribed health professional. Regulation 11.1 covers a registered nurse, psychiatric nurse or nurse practitioner employed by a regional health authority with five years' mental health experience in the past 10 who practises in a rural or remote area, and only if no attending physician will be available within a reasonable period. Supervised psychiatry residents also qualify.

How long is a Form A valid?

The person cannot be conveyed more than seven days after the date of the examination on which the certificate is based. Once the person arrives where the psychiatric examination will happen, The Mental Health Services Act requires that examination as soon as reasonably practicable and in all cases within 24 hours.