Certificate Respecting an Impairment

This form is used to certify that a person 18 or over has a severe mental or physical impairment over an extended period.

Instead of using this form, you can send us a copy of federal form T2201, Disability Tax Credit Certificate, to certify that you or a person in respect of whom you are claiming a tax credit in your return has a severe and prolonged impairment.

However, use this form if you are required to provide us with a certificate confirming:

  • that the impairment is considered severe because of the time spent undergoing therapy that is essential to sustain a vital function; or
  • that someone in respect of whom you are claiming the tax credit for caregivers needs assistance in carrying out a basic activity of daily living because of a severe and prolonged impairment.

To complete the form, save it to your computer and open it in Adobe Reader.

Our downloadable documents may not comply with Web accessibility standards. If you are having problems using them, please contact us.

2020-10 version

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