Get Canada Sc Ins5216b 2023-2026

The Canada SC INS5216B form serves as a medical certificate for Employment Insurance Compassionate Care Benefits. This guide will provide you with clear, step-by-step instructions to confidently fill out this important document online.

Follow the steps to complete the form accurately.

1. Press the ‘Get Form’ button to access the electronic version of the Canada SC INS5216B form.
2. Begin by entering the patient's last name and given names in the designated fields.
3. Fill in the date you last examined the patient using the format (YYYY-MM-DD), and enter their date of birth.
4. Confirm if the patient has a serious medical condition and significant risk of death within the next 26 weeks by selecting 'Yes' or 'No' in the provided options.
5. Indicate whether the patient requires care and/or support from one or more family members over the next six months by selecting the appropriate options.
6. If you are certifying conditions that applied earlier, specify the date (YYYY-MM-DD) in the provided field.
7. Provide your professional opinion about the patient's ability to consent to the release of medical information by selecting 'Yes' or 'No' and elaborating as necessary.
8. Sign the form by selecting your designation as either a Medical Doctor or Nurse Practitioner, then fill in the date.
9. Complete the contact information section with your name, contact details, and relevant registration numbers.
10. Finally, review the form for accuracy, then save changes, and download, print, or share the form as needed.

Ensure to complete all required fields and submit your document online for timely processing.