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Medical Certificate - Student’s dependent child - Major Functional Disabilities and Mental Disorder

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Form number: 1015B

This form is to be used for applications relating to the September 1, 2021 – August 31, 2022 award year.

You need to use this form if you child has a major functional or mental disorder and you are applying for the Loans and Bursaries Program. 

This form will not be considered valid unless it has been filled out by a doctor.

Download the form

Digital transmission

Print the form, have your doctor fill it out, and then scan it. Use your online file to upload the form.

Other way to submit your document

Mail

If you are unable to submit this form digitally you can mail it to us. Print the form, have your doctor fill it out and mail it to the address shown on the form itself.