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HLTH 3519

Certificate of Discharge

Form 19 is proof of discharge. A former patient may need it to show that an involuntary admission has ended, and the facility director must provide it when the person, or someone for them, asks.

At a glance

Checked October 2026

Form number
HLTH 3519
Issued by
BC Ministry of Health
Where
British Columbia
Completed by
Director of the designated facility
Format
Fillable PDF
Language
English

What Form 19 is for

Section 36 of BC’s Mental Health Act lets the director discharge a patient from a designated facility. A discharged person can ask for a certificate of discharge, and the director must provide one, signed, in the prescribed form. Form 19 is that certificate. It names the patient, the facility and the date of discharge.

Discharge also ends the effect of every application, certificate and warrant made before it, so a later admission starts again with a Form 4.1.

Who completes it

The director of the designated facility, or a person they have authorized, completes and signs it. The patient doesn’t sign. A community physician sees Form 19 mostly when a patient asks how to get one, or brings a copy to an appointment.

How to fill in the certificate

Patient, facility and date

Print the patient’s first and last name, the designated facility and the discharge date. Use the date of actual discharge, which can differ from the date the decision was made.

Director’s signature

The director signs, dates and prints their name.

Common reasons it’s delayed

  • The request goes to the community physician instead of the facility.
  • The discharge date doesn’t match the facility record.
  • Signed by someone without the director’s authority.

Submitting and who pays

The director gives the certificate to the former patient or the person who applied for them. The Act doesn’t mention a fee for it.

Get the official form

Download the current version from BC Ministry of Health each time. Forms change without notice, and an old edition can be returned.

Official page ↗ PDF ↗

Medulla Forms

Fill HLTH 3519 from the visit and the chart.

Upload the fillable PDF to your practice's forms once. Medulla fills it from the visit and the chart open in your EMR, leaves blank anything the record doesn't support, and opens the form for your review. When it's done, save it to the patient's chart in one click.

Free 1-month trial. No credit card required.

Sources for this guide

Questions

Questions we hear a lot.

Is a Form 19 issued automatically at discharge?

No. Section 36 requires the director to provide the certificate when they receive an application by or on behalf of the discharged person.

Can a family physician sign Form 19?

Only if they are acting as the director. The form is signed by the director of the designated facility, which under the Act includes a person the director has authorized.

What happens to earlier certificates after discharge?

Section 36 says an application, request, medical certificate or warrant made before discharge has no effect after it. A new admission needs new certificates.

Is patient information secure?

Yes. Medulla has a SOC 2 Type II report from an independent auditor, is HIPAA, PIPEDA, and PHIPA compliant, and is built and hosted in Canada, so patient data stays in the country and never gets pasted into consumer AI tools. Everything is encrypted in transit and at rest. See how we protect patient data.

More questions? Browse help.medulla.ca.