Mental Health Act Forms

Mental Health Act

Most Mental Health Act (MHA) forms below were updated on September 30, 2020 to align with changes to MHA.

Be sure to destroy old unused copies of forms. Some of the amendments are critical to meeting the updated requirements of the act.

Using These 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 each of the MHA forms below.

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.

  • MH1977 Form 1 - Admission Certificate
  • MH1978 Form 2 - Renewal Certificate
    UPDATE Mental Health Act Admission and Renewal Form Completeness Review. This form is intended to be completed at designated facilities only, following processes approved by facility/zone leadership. Please ensure your facility/zone have adopted this form for use and consult with your supervisor management on reporting processes.
  • 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
  • MH1989 Form 13 - Notice of Hearing Before Review Panel
  • MH1990 Form 14 - Decision of Review Panel Regarding Mental Incompetence to Make Treatment Decisions
  • MH1991 Form 15 - Decision of Review Panel Regarding Treatment
  • MH1992 Form 16 - Decision of Review Panel Regarding Transfer Back to a Correctional Facility
  • MH1993 Form 17 - Decision of Review Panel Regarding Admission Certificates, Renewal Certificates or Community Treatment Orders
  • MH12617 Form 17.1 - Decision of Review Panel Regarding Order for the Board to Issue a Community Treatment Order
  • MH1994 Form 18 - Decision of Review Panel Regarding Renewal Certificates & Community Treatment Orders (Deemed Application)
  • MH2000 Form 19 - Issuance of Community Treatment Order
  • MH2001 Form 20 - Renewal of Community Treatment Order
  • MH2002 Form 21 - Community Treatment Orders Amendments to Community Treatment Order
  • MH2003 Form 22 - Community Treatment Order Cancellation or Expiry
  • MH2004 Form 23 - Community Treatment Order Apprehension Order
  • MH2005 Form 24 - Community Treatment Order Examination on Apprehension
  • MH2008 Form 25 - Community Treatment Order Noncompliance Report
    Update: The Community Treatment Order Written Statement form is now within Form 19, 20, & 21 and the Community Treatment Order Noncompliance Report is now Form 25