March 2019 By

Form 33 (Notice to Patient - Incapacity)

A Form 33 (Notice to Patient under Subsection 59(1) of the Act and under Clause 15(1) (a) and 15.1 (a) of Regulation 741) is given to a patient anytime you deem them incapable to consent to treatment, manage their own property, and/or manage the collection/release/use of their health information.

Through a Form 33 you make the assessment that the patient is incapable to (1 or more of the following):

Incapacity Findings

Incapacity Type Assessment Needed Additional Forms Next Steps
Treatment Informed Consent and Capacity Assessment None • You must immediately find a substitute decision maker (SDM)
• If you are unable to locate an SDM (after make a reasonable effort to find one) you must contact The Office of the Public Guardian and Trustee (OPGT), and have the Public Guardian and Trustee take over decision-making.
Property/Finances Financial Capacity Assessment Form 21 • Contact The Office of the Public Guardian and Trustee (OPGT)
• Give this to patient: Handout for Patients Deemed Financially Incapable
Collection/Use/Release of Health Information - None -

After a Form 33 is issued to a patient, a Form 50 (Confirmation of Rights Advice) is filled out and given by a Rights Adviser to the physician as a notice. This confirms to the physician that rights advice was provided to the patient and will also inform the physician if the patient applied for a hearing.

For Providers

Download Form 33