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Information for MAiD providers: revised forms and protocol update

Apr 2, 2019

The Ministry of Health has made minor updates to the provincial forms for Medical Assistance in Dying (MAiD), in response to feedback from practitioners and pharmacists after the new federal reporting regulations came into effect last fall. The protocol has aslo been updated.

Using current forms when reporting

The revised forms have been loaded on the Ministry of Health's website. Practitioners and pharmacists are reminded they must download the forms from the website each time they use them to ensure they are always accessing the most current versions. Please refer to the end of this announcement for a summary of the changes.

All provincial and federal reportable information is included in B.C,'s provincial forms for MAiD. This ensures that the practitioner or pharmacist's completion and submission of their provincial form(s) to the BC Ministry of Health fulfill their provincial and federal reporting obligations.

Protocol update

The British Columbia Pharmacy Protocols guidance document and Prescription for Medical Assistance in Dying have been updated. These resources are available to physicians, nurse practitioners and pharmacists through each Health Authority and through the College of Physicians and Surgeons of British Columbia and the College of Pharmacists of British Columbia.


Contact the BC Ministry of Health - Medical Assistance in Dying Oversight Unit

Detailed form changes

1633 Assessment Record (Assessor) Form and 1634 Assessment Record (Prescriber) Form

  • Minor changes to clarify the meaning of specific questions including:
    • any prior consultations with the patient prior to their request for MAiD;
    • the assessment of the patient and if they are in an advanced state of irreversible decline; and
    • the conclusion regarding the patient's eligibility for MAiD.
  • There have been a couple of additions to the forms to better reflect federal legislation, including:
    • A definition of the 10 clear days, noting that 10 clear days begins on the day on which the request was signed by the patient (day 0) and the day on which MAiD was provided (day 11 or later); and
    • an affirmation of the agreement between the assessor and prescriber if MAiD has proceeded within less than 10 clear days.

1641 Dispensing Record (Pharmacist) Form

  • The affirmations of compliance with the provincial regulatory college standards have all been aligned on the left margin.
  • A permanent label has been created for the return of the sealed back-up IV kit.

The instructions for the 1633 Assessment Record (Assessor), 1634 Assessment Record (Prescriber) and 1641 Dispensing Record (Pharmacist) have also been updated to reflect these changes.