Medical Assessment for Temporary Representation (QC)

Temporary representation lets a Québec court authorize someone to perform one specific legal act, such as filing for divorce or selling a building, for an adult who cannot do it. This assessment documents the physician's examination and opinion on the person's capacity for that single act. If it concludes incapacity, it goes with the psychosocial assessment to the applicant, and a legal professional retained by the family files the court application.

Who completes it

A physician who has personally examined the person completes the whole form, including the opinion in Section 7 and the signature in Section 8. A social worker completes the separate psychosocial assessment for temporary representation, and the form advises speaking with that assessor beforehand.

Submitting and payment

How to submit it
Transmit the report only if it concludes incapacity: send the original to the applicant who attested under oath that they will apply for temporary representation, a copy to the appointed psychosocial assessor and a copy to the person concerned, and keep a copy on file.
Who pays
For general practitioners, the Curateur public's fact sheet for physicians points to the RAMQ fee-for-service manual (Section B, Letter of Agreement 223) for medical assessments under legal representation measures.

Good to know

  • Use this form when the proposed temporary representative is a relative or a professional; if the Curateur public would act, the tutorship assessment forms are required instead.
  • Temporary representation covers a single act and ends once it is performed; it cannot serve as a stopgap while a tutorship or a protection mandate homologation is pending.
  • The Civil Code requires an examination of the person: the form cannot be completed from a file alone, and the examination dates and people consulted must be recorded.
  • Older versions of the Curateur public's assessment forms are no longer accepted for new evaluations, so download the current edition before each assessment.

Get the official form

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

Medical assessment (temporary representation)

Évaluation médicale – Représentation temporaire

Fill it with Vero

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.

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 change without notice, so download the current version from the official page before you fill it in.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

When does temporary representation fit better than a tutorship?

When the need is limited to one act, such as renouncing a succession, selling a building or retaining a lawyer. The form notes that if the person could not manage what follows, for example large sale proceeds, a tutorship may be the better course of action.

What does the physician conclude on this form?

Section 7 asks for a single conclusion: the person is either capable or incapable of performing the act described in Section 3. Section 6 supports it with history, examination, paraclinical results and an assessment of understanding, appreciation, reasoning and ability to communicate a decision, plus the person's wishes and preferences.

Is the temporary representation assessment available in French?

Yes. The Curateur public posts it as Évaluation médicale dans le cadre d'une demande de représentation temporaire, alongside the English edition and the matching psychosocial assessment in both languages, on its forms page for the health and social services network.