Criteria for an
Independent Witness

Any person who is at least 18 years of age and who understands the nature of the request for medical assistance in dying may act as an Independent Witness, except if they:

• Know or believe that they are a beneficiary under the will of the person making the request, or a recipient, in any other way, of a financial or other material benefit resulting from that person’s death
• Are an owner or operator of any health care facility at which the person making the request is being treated or any facility in which that person resides
• Are an unpaid caregiver

Important information

• If you need help locating a MAID assessor or finding the correct forms to request MAID in your province or territory, start here. If you have questions navigating your request for MAID, or need to speak with someone one-on-one, you can contact the Dying With Dignity Canada Support Team at support@dyingwithdignity.ca or 1-844-395-3640.
• For virtual witnessing, the witness volunteer will need to confirm the patient’s identity (for example, with a health card, or hospital band). The patient can fill out the Patient Information section on their form, but must not sign and date the section confirming their consent to request MAID.  The signature and date is what must be witnessed on the video call. The patient will then sign their own physical paper copy of the form, and the witness will fill out a paper copy on their end. Once the video call is complete, the volunteer witness will scan and email the patient (or the patient’s point of contact) a digital copy of their filled-out form, which can then be combined with the patient’s signed copy and given to their MAID Assessor.

Before filling out the form below, we encourage you to contact your Care Coordination Service to get the MAID process started.