1 The date on which the practitioner referred, or transferred the care of, the patient.
2 An indication of whether the practitioner referred, or transferred the care of, the patient for any of the following reasons, and if so, an indication of the reason:
(a) the referral or transfer of care was the result of the application of the policies on medical assistance in dying of a hospital, a residential care facility or a palliative care facility, in the case where the patient was in a hospital or such a facility;
(b) providing medical assistance in dying to the patient or assessing the patient to determine whether they meet the eligibility criteria would have been contrary to the practitioner’s conscience or beliefs;
(c) the patient asked the practitioner to refer them or transfer their care;
(d) the practitioner was of the view that they lacked the relevant expertise to provide medical assistance in dying.
3 An indication of whether the practitioner had determined that the patient met or did not meet all of the eligibility criteria before they referred, or transferred the care of, the patient.
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