Form 4: Capacity Assessment Report - Alberta Human Services - Government of Alberta

Form 4: Capacity Assessment Report

Download Form 4: Capacity Assessment Report (Guardianship or Trusteeship or Both) (PDF, 215.64 KB)


The Capacity Assessment Report is a required court form when making a co-decision-making, guardianship or trusteeship application. For a guardianship and/or trusteeship application, the Capacity Assessment Report (Guardianship or Trusteeship or Both) Form 4 must be used.

“Capacity” means in respect of the making of a decision about a matter, the ability to understand the information that is relevant to the decision and to appreciate the reasonably foreseeable consequences of a decision and a failure to make a decision.

An adult has the right to refuse to undergo, or to continue with, a capacity assessment and has the right to have a person present to assist in feeling comfortable during the capacity assessment.

Persons designated as capacity assessors are:

  • Registered Medical Practitioners
  • Regulated member of the College of Alberta Psychologists.
  • Other health professions may be designated as capacity assessors if the person:
    1. Is a regulated member of a college of a heath profession (registered nurses, registered psychiatric and mental deficiency nurses, occupational therapists, and social workers.)
    2. Has successfully completed a course for capacity assessors.
    3. Meets any other requirements set by the Minister.

Date of capacity assessment form: Unless an application contains a request for the Court to accept a capacity assessment report that was conducted earlier, a capacity assessment report submitted in respect of an application must be dated not more than 6 months before the date the application is started.

Fees: A capacity assessor may charge a fee for a capacity assessment including the capacity assessment report up to a maximum of:

  1. $500 if the capacity assessment relates exclusively to the adult’s capacity to make decisions about either personal matters (guardianship) or financial matters (trusteeship).
  2. $700 if the capacity assessment relates to the adult’s capacity to make decisions about personal matters and financial matters.
  3. The Court may, on application, allow a higher fee for a capacity assessment on the basis of the complexity.
  4. The applicant may request the Crown pay the fees for a capacity assessment. The Public Guardian must be satisfied that it would be a financial hardship for the applicant and the adult, and would recommend to the Minister that the Crown pay the fees. The Minister may pay the fees for only one capacity assessment of an adult in a calendar year.
  5. If an applicant pays for the Capacity Assessment, and it was a hardship to do so the applicant may make a request in their application to the Court that the Court order the Crown to pay for reasonable disbursements made during the application. If the order is granted, the Capacity Assessment Fee can be recovered by providing the Public Guardian with proof of payment of the Capacity Assessment Report fee.
Modified: 2016-09-15
PID: 16711

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