The attending physician uses this Mental Health Act certificate to admit a patient to an Ontario psychiatric facility as an involuntary patient. The physician certifies a personal examination, that the patient is not suitable for voluntary or informal status, and that the Box A risk-of-serious-harm or Box B criteria are met. The certificate is valid for 14 calendar days, including the day it is signed.
The attending physician completes and signs the certificate after personally examining the patient. The signing physician must then give the patient a Form 30 notice and notify a rights adviser.
Download the current version from the source each time; forms change without notice.
Form 3 - Certificate of Involuntary Admission
Formule 3 - Certificat d'admission en cure obligatoire
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A Certificate of Involuntary Admission is valid for 14 calendar days, including the day on which it was signed. To continue involuntary status after that, the attending physician must examine the patient and complete Form 4, the Certificate of Renewal, if the criteria are still met.
The signing physician must promptly give the patient a properly executed Form 30 notice and notify a rights adviser. The rights adviser must meet the patient and explain the significance of the certificate and the right to have it reviewed by the Consent and Capacity Board.
Yes. The French version, Formule 3, Certificat d'admission en cure obligatoire, is posted as form 3773-41 in Ontario's Central Forms Repository, alongside the English 6429-41 (2000/12) edition, so the certificate can be completed in either official language.