PDF Version [Printer-friendly - ideal for printing entire document] BLOOD SAMPLE CERTIFICATE REGULATION 333/83 Published by Quickscribe Services Ltd. Updated To: [includes B.C. Reg. 343/2012 amendments (effective November 23, 2012)] Important: Printing multiple copies of a statute or regulation for the purpose of distribution without the written consent of Quickscribe Services Ltd. is strictly prohibited. Quickscribe offers a convenient and economical updating service for those who wish to maintain a current collection of hard copy legislation. Go to www.quickscribe.bc.ca/hardcopy/ for more details. B.C. Reg. 333/83 Go to http://www.quickscribe.bc.ca/disclaimer/ to view the Disclaimer. BLOOD SAMPLE CERTIFICATE REGULATION 333/83 BLOOD SAMPLE CERTIFICATE REGULATION 333/83 B.C. Reg. 333/83 [includes B.C. Reg. 343/2012 amendments (effective November 23, 2012)] Contents 1. Form of certificate SCHEDULE [Provisions of the Motor Vehicle Act, RSBC 1996, c. 318, relevant to the enactment of this regulation: section 227 (7)] Form of certificate 1. B.C. Reg. 333/83 The form and content of certificates to be used for the purpose of section 227 of the Motor Vehicle Act are as set out in the schedule. Page 2 of 5 Quickscribe Services Ltd. BLOOD SAMPLE CERTIFICATE REGULATION 333/83 SCHEDULE Form 1 [am. B.C. Reg. 232/2005] Certificate of Taking a Blood Sample I, ___________________________________ of ______________________________ am a medical practitioner registered nurse authorized under an enactment to practise as a registered nurse in British Columbia certified member of the Canadian Society of Laboratory Technologists certified laboratory assistant member of the Canadian Society of Laboratory Technologists _________________________________ , a person employed by a hospital who in the normal course of my employment takes blood samples AND I DO HEREBY CERTIFY: THAT, on __________________ [date] at _____________________ [time] at __________________________________ , Province of British Columbia pursuant to a demand made under section 225 (1) of the Motor Vehicle Act, R.S.B.C. 1996 pursuant to section 225 (2) of the Motor Vehicle Act, R.S.B.C. 1996 I did take a sample of the blood of a person identified to me as ________________________ . I marked the blood specimen container containing the sample of blood with the inscription I gave the blood specimen container to ____________________________ DATED _________________ [day, month, year] at _____________________________ in the Province of British Columbia. _____________________________ Taker B.C. Reg. 333/83 Page 3 of 5 Quickscribe Services Ltd. BLOOD SAMPLE CERTIFICATE REGULATION 333/83 Form 2 [en. B.C. Reg. 343/2012] Certificate of Medical Practitioner or Nurse Practitioner I, _______________________________ , medical practitioner/nurse practitioner (circle one only), observed a person identified to me as __________________________ at ____________________ [place] on _____________________ [day, month, year] at _________________ [time], at which time I formed the opinion that _____________________________ was incapable due to ___________________________________________________________________ of comprehending the nature of a demand under section 225 (1) of the Motor Vehicle Act, R.S.B.C. 1996, c. 318. DATED _________________ [day, month, year] at _____________________________ in the Province of British Columbia. _____________________________ Medical Practitioner/Nurse Practitioner B.C. Reg. 333/83 Page 4 of 5 Quickscribe Services Ltd. BLOOD SAMPLE CERTIFICATE REGULATION 333/83 Form 3 Certificate Of Analysis Of A Blood Sample I, __________________________ , being a person approved by order of the Attorney General of British Columbia to analyze a blood sample taken under section 225 of the Motor Vehicle Act, R.S.B.C. 1996, DO HEREBY CERTIFY: THAT, on _________________ [day, month, year] at ______________________________ there was received by me ____________________________ which bore the following inscription: That I marked the said ___________________________ with the inscription: That I performed an analysis on the blood ___________________ within the said ____________________ using a method approved as suitable for the purposes of section 225 of the Motor Vehicle Act, R.S.B.C. 1996 by order of the Attorney General of British Columbia, to wit That I found the blood to contain ________________ milligrams of alcohol in 100 millilitres of blood. DATED _______________ [day, month, year] at _______________________ in the Province of British Columbia. ___________________________ Analyst [Provisions of the Motor Vehicle Act, RSBC 1996, c. 318, relevant to the enactment of this regulation: section 227 (7)] B.C. Reg. 333/83 Page 5 of 5 Quickscribe Services Ltd.