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Certificate of Physician and Property Owner

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FORM B - CERTIFICATE OF PHYSICIAN AND PROPERTY OWNER

under the Home Owner Grant Act

IT IS AN OFFENCE (SUBJECT TO A PENALTY OF UP TO $10,000) TO MAKE A FALSE APPLICATION FOR THE HOME OWNER GRANT.

Telephone: 250 356-8904

Toll-free: 1 888 355-2700

Email: hogadmin@gov.bc.ca

gov.bc.ca/homeownergrant

PROPERTY FOLIO NUMBER


PART A – TO BE COMPLETED BY PHYSICIAN (please type or print clearly)

PATIENT NAME

PATIENT ADDRESS

POSTAL CODE

a) What is the nature of the disability?

b) When did this disability occur?

c) Is the disability permanent?

d) Is remedial therapy available that would significantly lessen the disability?

e) In order to manage normal daily functioning in the home, is this disability sufficiently severe that the patient requires:

(i) physical assistance in the form of regular and extensive supervision or care?

(ii) structural modifications to his or her home?

PHYSICIAN NAME (please type or print clearly)

PHYSICIAN ADDRESS

POSTAL CODE

PHYSICIAN CERTIFICATION - I have read the guidelines and hereby certify that the answers to the above questions are, in my professional opinion, true and apply to the patient named above.

PHYSICIAN'S SIGNATURE

DATE SIGNED


PART B – TO BE COMPLETED BY PROPERTY OWNER (please type or print clearly)

a)

State how the person named in Part A above is related to you (see reverse for the definition of a relative).

b) I certify that to accommodate the needs of the person named in Part A above:

c) Please describe the nature of the physical assistance or the structural modifications you indicated in section b above.

PROPERTY OWNER NAME (please type or print clearly)

PROPERTY OWNER ADDRESS

POSTAL CODE

SIGNATURE

DATE SIGNED

PROPERTY OWNER CERTIFICATION - I understand that I must submit copies of the receipts with this form and that I must retain the original receipts and documentation supporting the costs referred to in section b (i), (ii) or (iii) above for a period of six years. I understand that I must provide the original receipts and documentation upon request by the municipal or provincial tax collector, or by the Home Owner Grant Administrator.

Please see the reverse for important information when completing this form.

Property Owner

If you are a property owner who qualifies for the home owner grant, and you have a permanent disability, or you are the spouse or relative of a person with a permanent disability who lives in your home, you may be eligible for an additional home owner grant.

A person who receives a disability pension or Worker’s Compensation Benefits does not automatically qualify as a person with a permanent disability.

To qualify for the additional grant, you must be incurring or have incurred the costs indicated in Part B, section b on this form.

You do not qualify for the additional grant if costs indicated in Part B, section b are covered and paid directly by a provincial agency, federal agency or by a private insurer through provision benefits or payments (for example, Worker’s Compensation Benefits and Insurance Corporation of British Columbia payments).

To apply for the additional home owner grant, you are required to complete the Form B for the first year that you apply. You complete Part B and the physician for the person with the permanent disability completes Part A. You send the following documents to the municipal or provincial tax collector:

• Form B,

• Application for Home Owner Grant, and

• copies of the receipts and documents supporting your costs and expenses.

You must keep the original receipts and documents listed above for a period of at least six years as these originals may be requested by the municipal or provincial tax collector, or by the Home Owner Grant Administrator.

Guidelines For Physician

As explained in the section above, this form is completed by a property owner who may qualify for an additional home owner grant because they have a permanent disability, or their spouse or relative who lives with them has a permanent disability.

If you are the physician for the person with the permanent disability, please complete Part A of this form.

Definitions

A relative is a child, grandchild, brother, sister, parent, stepparent or grandparent of the person with a permanent disability, or a person who stands in place of a parent to the person with a permanent disability.

Physical assistance is regular and extensive supervision or care necessary for the person with a permanent disability to manage normal daily functions in the home (for example, meal preparation, feeding or assistance with personal hygiene). Assistance for activities outside the home does not qualify.

Structural modifications are changes to the structure of the home that are necessary for the person with a permanent disability to manage normal daily functions in the home. Examples of structural modifications are building access ramps, widening of doorways, installation of an elevator or other lifting device.

Freedom of Information and Protection of Privacy Act (FOIPPA) – The personal information on this form is collected for the purpose of administering the Home Owner Grant Act under the authority of section 26(a) of the FOIPPA. Questions about the collection or use of this information can be directed to the Manager, Home Owner Grant Administration, PO Box 9991 Stn Prov Govt, Victoria, BC V8W 9R7. (Telephone: Victoria at 250 356-8904 or toll-free at 1 888 355-2700 and ask to be re-directed.)

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What the Certificate of Physician and Property Owner Is

The Certificate of Physician and Property Owner is a formal document that records a medical provider's statement about a patient's fitness or restrictions together with the property owner's authorization or acknowledgement regarding access, occupancy, or use of a specific property. It combines medical attestation and property-level consent so that employers, landlords, homeowners associations, or municipalities can confirm both clinical recommendations and property permissions in a single, signed record. The certificate is often used where a health condition affects housing, workplace accommodations, or access to communal facilities.

Why this combined certificate matters

Combining a physician attestation and property-owner acknowledgement streamlines verification when health conditions intersect with property access or accommodation needs. It creates a single evidentiary record linking clinical guidance to on-site permissions, reducing administrative back-and-forth and clarifying responsibilities for all parties.

Why this combined certificate matters

Typical users and stakeholders

The certificate is useful to parties who must verify both medical recommendations and property permissions before granting access or accommodations.

  • Employers managing workplace accommodations or onsite health restrictions, needing medical support and site permission aligned.
  • Landlords or property managers who must approve temporary occupancy changes linked to medical needs.
  • Healthcare providers supplying formal documentation to support a patient’s accommodation or access request.

Use the certificate to reduce repeated requests for documentation and to maintain a single signed record tying medical advice to property-level consent.

Representative signers

Physician

A licensed medical practitioner (MD, DO, NP, PA) who provides a clear clinical statement of limitations, required accommodations, or fitness for occupancy. Include license number and contact information to support verification and traceability.

Property Owner

The titled owner or authorized agent who affirms permission for the patient or occupant to use the property as stated. Include printed name, title (if agent), and a mailing address for official correspondence.

Essential data elements to include

Patient name: Full legal name
Physician details: License number and clinic
Property address: Street, city, state, ZIP
Effective dates: Start and end dates
Signatures: Physician and owner signatures
Contact info: Phone and email

Common preparation pitfalls to avoid

  • Leaving the physician license number or state blank, which can delay verification and acceptance by employers or housing authorities.
  • Using incomplete property descriptions (for example, a unit number omitted), causing confusion about which parcel is authorized.
  • Failing to specify effective dates or writing ambiguous periods like 'as needed', which complicates enforcement and renewal.
  • Collecting signatures without dating them or without witness/notary where required, reducing the document's evidentiary value.

Consequences of errors or omissions

Administrative delay: Permit or access postponement
Rejection risk: Request denied for missing data
Legal exposure: Liability from improper access
Privacy breach: HIPAA issues if mishandled
Notarization gap: Invalid if a notarized signature required
Worker disruption: Workplace accommodation delayed

Filling the Certificate: step-by-step

Follow these sequential steps to complete a clear, enforceable certificate that links the physician statement to the property owner acknowledgement.

  • 01
    1. Identify parties: Enter full legal names for patient, physician, and owner
  • 02
    2. Add medical findings: Physician states limitations, accommodations, and dates
  • 03
    3. Specify property: Give exact address and unit, include parcel ID if available
  • 04
    4. Sign and date: Collect dated signatures and any witness or notary

Typical document flow and handling

A predictable routing sequence reduces follow-up and clarifies custody of the certificate for enforcement or recordkeeping.

  • Prepare: Sender completes fields and attaches supporting records
  • Physician signs: Clinician signs and dates the medical attestation
  • Owner acknowledges: Property owner signs and notes any conditions
  • Distribute: Provide copies to employer, tenant, or file holder

Core components of a professional certificate

A complete Certificate of Physician and Property Owner should be structured to support verification, reduce ambiguity, and satisfy legal or administrative requirements.

Header

Clear title, document purpose summary, and version or form ID to prevent confusion across similar records.

Patient block

Full legal name, date of birth, and contact details to uniquely identify the person receiving medical guidance.

Clinical statement

Physician's findings, recommended accommodations or restrictions, and effective period with MM/DD/YYYY formatting for clarity.

Property details

Exact street address, unit, parcel or lot number, and any limits on access, use, or occupancy tied to the medical guidance.

Signatures

Dated signatures from physician and property owner, plus printed names and professional credentials for verification.

Supporting notes

Optional attachments list (medical records, property deed excerpt) and contact for follow-up verification requests.

Use-case examples showing typical application

These real-world scenarios illustrate how the certificate resolves practical questions about health-related property access and accommodations.

Case Study 1

A tenant requests temporary on-site oxygen storage authorization from a landlord

  • The physician documents oxygen needs and safe storage measures
  • The property owner signs to permit placement in a designated area, reducing delay in setup while keeping a dated record of responsibilities and emergency contacts.

Case Study 2

An employer needs confirmation before allowing a medically necessary shift modification

  • The clinician specifies work restrictions and duration
  • The property owner of corporate housing acknowledges accommodation terms, linking clinical requirements to on-site access permissions and supporting HR compliance records.

Digital workflow settings for online completion

Configure these fields and routing rules when implementing the certificate in an electronic workflow to ensure correct sequencing and record integrity.

Field Configuration
Signature order Physician first | Owner second
Authentication Email + SMS code recommended
Notary option Enable RON or in-person as required
Audit trail Include IP, timestamp, and action log

Technical considerations for eCompletion and storage

Choose a platform that supports secure storage, detailed audit trails, and optional notarization to preserve legal value.

  • Document formats: PDF, DOCX supported
  • Integrations: Works with CRM and cloud storage
  • Authentication: Email, SMS, advanced options

Confirm the chosen system supports HIPAA where medical content is present, provides AES-256 encryption at rest, and retains a tamper-evident audit trail.

Timing and processing expectations

Processing timelines depend on who must review the certificate and whether additional verification or notarization is required.

Physician turnaround:

Typically 1–5 business days

Owner acknowledgement:

Often 1–3 business days

Notarization time:

Same day for in-person; RON varies

Employer review:

1–7 business days depending on HR

Record retention start:

Date of final signature

eSignature vendor comparison for this certificate

A concise pricing and capability snapshot showing typical entry-level costs and relevant compliance features for eSignature providers; signNow is listed first per vendor comparison conventions.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently asked questions and troubleshooting

Answers to common operational and legal questions when preparing a Certificate of Physician and Property Owner.


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