Two qualified health professionals, one of them a psychiatrist, use this form to place a person under a community treatment order in Alberta. Each records a separate examination within the preceding 72 hours and the facts behind their opinions; Part III sets out medications and providers, Part IV names the supervising professional and Part V records consent. The order lasts six months unless renewed or cancelled.
The issuing qualified health professional completes the Written Statement and Part I, and the second examiner completes Part II; either Part I or Part II must be completed by a psychiatrist. Treatment providers sign Part III, the supervising professional signs Part IV, and the person or substitute decision-maker signs Part V.
Download the current version from the source each time; forms change without notice.
Form 19 - Issuance of Community Treatment Order
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Two qualified health professionals, after separate examinations, one of whom must be a psychiatrist or hold a psychiatrist's authority under a declaration made under section 49(2) of the Act. Recovery Alberta's flowchart notes that examinations for issuing an order may be done remotely, including by video conference.
Six months from the day it is issued, unless it is renewed on Form 20 or cancelled earlier by a psychiatrist, a review panel or the Court of King's Bench. There is no limit on the number of renewals, and all parts of Form 19 must be completed within 72 hours of the first examination.
Consent is the default: from the person if competent, or from the substitute decision-maker under section 28(1) if not. The order can be issued without consent only if both professionals find a history of not obtaining or continuing necessary treatment in the community, and that the order is reasonable and less restrictive than keeping the person as a formal patient.