FORM 7 MENTAL HEALTH ACT, SECTIONS 12 AND 13CERTIFICATE OF INVOLUNTARY ADMISSION Two physicians must each complete separate copies of this form within 24 hours of the patients' arrival at the hospital.

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How to fill out the Canada Yukon YG(3989EQ)F3 online

The Canada Yukon YG(3989EQ)F3 form is essential for documenting the assessment of a patient in accordance with the Mental Health Act. This guide is designed to assist users in accurately completing the form online to ensure compliance with legal requirements.

Follow the steps to complete the form effectively.

  1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
  2. Fill in the patient’s name in the designated field at the top of the form. This identifies the individual undergoing examination.
  3. Enter the name and information of the medical practitioner completing the form, ensuring to provide details about their licensure in the Yukon Territory.
  4. Document the patient's usual place of residence and the date and time of examination. This establishes the context for the evaluation.
  5. In the section detailing the examination results, carefully describe the patient's mental state, including affective, cognitive, and behavioral observations.
  6. If applicable, indicate whether you are appending examination notes as evidence. Remember to file the original notes in the patient’s medical record.
  7. Complete the section regarding prior knowledge, detailing any information influencing your opinion on the patient's mental state.
  8. In the section for observations by others, make sure to document the source of the information, the identity of individuals who observed the patient, and any relevant descriptions of these observations.
  9. Select either option A or B regarding your medical opinion on the patient's mental health status. Provide detailed reasoning in support of your selection.
  10. Finally, ensure the form is dated and signed by the physician, and include the printed name. A witness signature is also required.
  11. Review all entries for accuracy before saving, downloading, printing, or sharing the completed form as needed.

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