Regulations for the Monitoring of Medical Assistance in Dying

1 The following information in respect of the patient for whom the substance was dispensed:

• (a) date of birth;

• (b) health insurance number and the province or territory that issued it or, in the case where they do not have a health insurance number or the pharmacist does not know the patient’s health insurance number, the province or territory of their usual place of residence on the day on which the pharmacist dispensed the substance.

2 The following information in respect of the pharmacist:

• (a) name;

• (b) the province or territory in which they practise and, if they practise in more than one province or territory, the province or territory in which they dispensed the substance;

• (c) the licence or registration number assigned to the pharmacist in the province or territory in which they dispensed the substance;

• (d) the mailing address and email address that the pharmacist uses for work.

3 The following information in respect of the practitioner who prescribed the substance or obtained the substance from the pharmacist:

• (a) name;

• (b) the licence or registration number assigned to the practitioner in the province or territory in which they received the request.

4 The following information in respect of the dispensing of the substance:

• (a) the date on which the substance was dispensed;

• (b) an indication of which of the following places describes where the pharmacist dispensed the substance or, if they dispensed the substance elsewhere, a description of that place:

  • (i) hospital pharmacy,

  • (ii) community pharmacy.