Scottish Statutory Instrument 2008 No. 51
Adults with Incapacity (Scotland) Act 2000 ("the Act")
Certificate of incapacity to accompany an application to the Public Guardian under
section 24C, 24D or 25
I (Full Name)
(Professional Address) in my capacity as
have examined the following patient on
(Address) (Date of Birth)
I am of the opinion that he/she is incapable in relation to decisions about, or incapable of acting to
safeguard or promote his/her interests in, the funds.
I am of the opinion that the patient named above is incapable in terms of section 27B of the Act because
mental disorder(2) and/or
inability to communicate because of physical disability(3)
Brief description of mental disorder/inability to communicate
(1) the person signing the certificate must be a registered and licenced medical practitioner; insert as
appropriate, e.g. GP, specialist in mental disorder
(2) mental disorder has the meaning given to it in section 328 of the Mental Health (Care and
Treatment) (Scotland) Act 2003, namely that it means any mental illness; personality disorder or
learning disability however caused or manifested, but an adult is not mentally disordered by
reason only of sexual orientation; sexual deviancy; transsexualism; transvestism; dependence
(3) on,or use of, alcohol or drugs; behaviour that causes, or is likely to cause, harassment, alarm or
distress to any other person; or acting as no prudent person would act.
(4) one of these must be deleted unless both apply.