Nurse Practitioner Series: Are you aware of the implications of completing a patient form?

Nurse practitioners, and at times, registered nurses, may be asked by their patients or required by legislation to complete forms to be submitted to a third party. This typically includes filling out a form or writing a letter on behalf of the patient for the purposes of gaining access to a benefit or confirming certain health information. Common examples of such requests include filling out forms to submit to government programs or agencies, completing disability claims, or providing letters to employers regarding fitness to work.

Clinical information and opinions communicated to third parties are likely to be relied upon to make decisions and, in many circumstances, determine entitlement to benefits. It is important that third party forms not be completed solely for the patient’s convenience , even if fulfilling the patient’s request may appear to help ease a patient’s burden. Nurses should endeavour to present information that truthfully and accurately reflects the patient’s clinical status and history based on a reasonable clinical assessment. When filling out forms, nurses may rely on observations made during the assessment and any of the patient’s reported symptoms and history. Nurses may also rely on the information contained in the patient’s clinical records or the results of the relevant diagnostic tests that have been ordered in the context of the clinical assessment. It is generally good practice to ascertain that the information relied upon is documented or readily available in the records so that the content of the report can be further explained and supported, if necessary.

If the clinical information or opinion appears doubtful, the author of the report or the form may be asked to substantiate the information. If the information or opinion cannot be substantiated, questions may be raised as to whether the nurse met the applicable standard of care or even whether there were improper motives for completing the form, potentially leading to complaints to the regulator.  Nurses may face legal consequences if they deliberately provided information that they knew to be false for the purpose of securing an advantage for themselves or their patients to which they would otherwise not be entitled.

In some cases, health profession regulatory bodies have disciplined health professionals for complaints related to filling out forms. In one case, a patient requested a review of a complaint made to the College of Physicians and Surgeons of Ontario (CPSO) disciplinary body, alleging that their physician failed to provide proper care by refusing to complete a disability tax credit form. The patient stated that they requested the form be completed, but the physician wrote a letter, without having seen the patient, stating that they would not complete the form. The CPSO disciplinary committee found that while it is within a provider’s rights to decline completing a form, it was reasonable for the patient to expect that the physician would have met with the patient to review the information regarding form completion.¹

In another case, a patient requested a review of a CPSO decision regarding her complaints about two physicians. The patient alleged that one of the physicians had failed to complete a sick note, failed to complete a pension retirement form, and refused to sign a functional ability form for employment. The patient also alleged that the other physician refused to provide sick notes and complete an employment insurance form. The CPSO committee found that while the first physician acted reasonably when they refused to complete the patients forms due to lacking expertise, it was the physician’s responsibility to assist the patient in identifying the correct person to complete the forms, such as a psychiatrist or an occupational therapist.²

CNPS beneficiaries can contact CNPS at 1-800-267-3390 to speak with a member of CNPS legal counsel. All calls are confidential.

1.D.P. v A.N., 2020 CanLII 30609 (ON HPARB), <https://canlii.ca/t/j6sbj>

2.AM v SDN, 2014 CanLII 2455 (ON HPARB), <https://canlii.ca/t/g2tvx>

Published May 2018; Revised November 2024

THIS PUBLICATION IS FOR INFORMATION PURPOSES ONLY. NOTHING IN THIS PUBLICATION SHOULD BE CONSTRUED AS LEGAL ADVICE FROM ANY LAWYER, CONTRIBUTOR OR THE CNPS. READERS SHOULD CONSULT LEGAL COUNSEL FOR SPECIFIC ADVICE.