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Forms

Instructions for opening and using forms:

  1. Find the form you want to access in the list below.
  2. Click on the link for the form. This will take you to the Ontario Government Central Forms Repository (except for the Cancellation of Incapacity Form).
  3. Right-click on the Download button
    1. Select Save Link As from the dropdown menu
    2. Choose the location on your computer to where you want to download the form (for example Downloads or Desktop)
    3. Click Save
  4. Alternatively, just click on Download to save to the default location on your computer
    1. Important: Do not attempt to open the file from a link that appears at the top or bottom of your screen. This will produce a message that the file cannot be opened.
  5. Go to the location on your computer to where you downloaded the form (for example Downloads or Desktop)
    1. Open the form from that location using Adobe Reader.
  6. Fill in the form, including as much information as possible
  7. Save the completed form to your computer
  8. If the completed form cannot be saved, “print the form as a PDF” to save it
    1. Select File and then select Print
    2. Select Adobe PDF or Microsoft Print to PDF from the printer dropdown menu
    3. Click Print
    4. Create a name for your completed form
    5. Click Save
  9. Send the saved completed form by email to ccb@ontario.ca

Note that forms may also be printed out and completed by hand. Completed forms may also be sent by fax or regular mail, however email is recommended for fastest service.

You will need Adobe Reader to use these forms. To download the free Adobe Reader please visit the Adobe website ( https://get.adobe.com/reader/)

The following is a listing of applications and notices to the Board:


Health Care Consent Act

Form A - Application to the Board to Review a Finding of Incapacity under Subsection 32(1), 50(1) or 65(1) of the Act

Form B - Application to the Board to Appoint a Representative under Subsection 33(1), 51(1) or 66(1) of the Act

Form C - Application to the Board to Appoint a Representative under Subsection 33(2), 51(2) or 66(2)

Form D - Application to the Board for Directions under Subsection 35(1), 52(1), or 67(1) of the Act

Form E - Application to the Board for Permission to Depart from Wishes under Subsection 36(1), 53(1) or 68(1) of the Act

Form F - Application to the Board with Respect to Place of Treatment under Subsection 34(1) of the Act

Form G - Application to the Board to Determine Compliance under Subsection 37(1), 54(1) or 69(1) of the Act

Form H - Application to the Board to Amend the Conditions of or Terminate the Appointment of a Representative under Subsection 33(7) and (8), 51(6) or 66(6) of the Act

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Mental Health Act

Form 16 - Application to the Board to Review a Patient's Involuntary Status under Subsection 39(1) of the Act

Form 17 - Notice to the Board of the Need to Schedule a Mandatory Review of a Patient's Involuntary Status under Subsection 39(4) of the Act

Form 18 - Application to the Board to Review a Finding of Incapacity to Manage Property under section 60 of the Act

Form 25 - Application to the Board to Review the Status of an Informal Patient who is a Child between 12 and 15 Years of Age under Subsection 13(1) of the Act

Form 26 - Notice to the Board of the Need to Schedule a Mandatory Review of the Status of an Informal Patient who is a Child between 12 and 15 Years of Age under Subsection 13(2) of the Act

Form 48 - Application to Board to Review Community Treatment Order and Notice to Board by Physician of Need to Schedule Mandatory Review of Community Treatment Order

Form 51 - Application to the Board for Section 41.1 Orders under Subsection 39(6) of the Act

Form 52 - Application to the Board for an Involuntary Patient's Transfer to Another Psychiatric Facility under Section 39(8) of the Act

Form 53 - Application to the Board to Vary or Cancel Section 41.1 Orders of the Board under Section 39(9) of the Act

Form 54 - Application to the Board to Vary or Cancel Section 41.1 Orders of the Board under Section 39(10) of the Act

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Personal Health Information Protection Act

Form P1 - Application to the Board to Review a Finding of Incapacity to Consent to the Collection, Use or Disclosure of Personal Health Information under Subsection 22(3) of the Act

Form P2 - Application to the Board to Determine Compliance under Subsection 24(2) of the Act

Form P3 - Application to the Board to Appoint a Representative under Subsection 27(1) of the Act

Form P4 - Application to the Board to Appoint a Representative under Subsection 27(2) of the Act

Form P5 - Application to the Board to Amend the Conditions of, or Terminate the Appointment of a Representative under Subsection 27(7) or (8) of the Personal Health Information Protection Act

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Substitute Decisions Act

Form 18 - Application to the Board for a Review of a Finding of Incapacity to Manage Property under Subsection 20.2(1) of the Substitute Decisions Act

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Child, Youth and Family Services Act

Form Y1 - Application to the Board to Review a Determination of Incapacity under Subsection 304(3) of the Child, Youth and Family Services Act

Form Y2 - Application to the Board to Determine Compliance under Subsection 302(2) of the Child, Youth and Family Services Act

Form Y3 - Application to the Board to Appoint a Representative under Subsection 305(1) of the Child, Youth and Family Services Act

Form Y4 - Application to the Board to Appoint a Representative under Subsection 305(2) of the Child, Youth and Family Services Act

Form Y5 - Application to the Board to Amend the Conditions of, or Terminate the Appointment of a Representative under Subsection 305(8) or (9) of the Child, Youth and Family Services Act.

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