Mental Health Act Forms

See the Mental Health Act: Pathways for Examinations at a Designated Facility table for an explanation of the different processes, pathways, and examination considerations for several of the MHA forms below.

Effective July 13, 2023 any forms below marked with an * can be completed in Connect Care as a digital eForm. Any Connect Care user with the authority to complete the eForm version is encouraged to do so.

If you are not a Connect Care user, it is recommended that forms are accessed from this page as needed to avoid the risks associated with the use of outdated forms.

Government of Alberta Forms

These MHA forms can be:

• completed on the computer and then printed and signed or
• printed, then completed by hand and signed.

For best results when printing forms, use the print function at the bottom of the form.

Note: Forms may not be altered in any way.

Scheduled Maintenance

Forms are unavailable between 2:00 a.m. & 2:15 a.m. nightly for server maintenance. During this time, you will not be able to access forms.

• MH1977 Form 1 - Admission Certificate*
  • Completeness Review - Mental Health Act Admission Certificate (Form 1)
  • Completeness Review - Mental Health Act Renewal Certificate (Form 2)
  • MH12614 Form 2.1 - Cancellation of Admission Certificate or Renewal Certificate*
  • MH1979 Form 3 - Order to Return a Formal Patient to a Facility*
  • MH1980 Form 4 - Certificate of Transfer into Alberta
  • MH1981 Form 5 - Transfer of Formal Patient to a Jurisdiction Outside Alberta
  • MH1982 Form 6 - Memorandum of Transfer to Another Facility*
  • MH1983 Form 7 - Information
  • MH1984 Form 8 - Warrant
  • MH1985 Form 9 - Extension of Warrant
  • MH1986 Form 10 - Statement of Peace Officer on Apprehension
  • MH1987 Form 11 - Certificate of Incompetence to Make Treatment Decisions
  • MH1988 Form 12 - Application for Review Panel Hearing
    • Note: A Form 12 must be submitted to the Review Panel Chair for the appropriate geographical area