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Deprivation of Liberty Safeguards Standard Forms

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On 27/2/09 the Department of Health, and the Welsh Assembly government, separately published final versions of all DOLS-related forms, for managing authorities, supervisory bodies etc. These forms are not compulsory but their use is encouraged. Forms were last updated in March 2011 (at the time of writing).

The forms

England Wales

Extract from DH website

The information on this page was last updated on 3 March 2011.

The set of documents and forms published here constitute the current version of the forms developed to date, for both supervisory bodies and for managing authorities.

Importantly the content has been changed several times since the versions of the forms thaty were posted on the DH website in February 2009.

In Februay 2010 a change was made so that in Box D1 A of Form 9 “Eligibility Assessment” there is now only one yes box and one no box whereas previously there were two of each. Those changes were made to reflect the AND between questions (i) and (ii) in box D1 A and the answer needing to be yes to BOTH of those questions or no to BOTH of those questions. Previously there was an option incorrectly to be able to answer yes to one and no to the other question or vice versa.

Further changes were made in November 2010 to Forms 4 and 10, and now in March 2011 to forms 1, 2 and 4.

The November 2010 change in relation to Form 4 is in relation to B7. It is now only possible to record a single disability in either A or B or C. It is possible within A and B to make further entries but it is no longer possible to make entries into combinations of A, B and C.

The disability recorded should be the one that is causing the person’s current incapacity.

The change in relation to Form 10 is in relation to PART F — BEST INTERESTS REQUIREMENT IS MET the following text has been added “If you are recording a Part 8 review assessment simply record the maximum authorisation period already granted and ignore Box F2".

This reflects the fact that although best interests assessors are required when carrying out a Part 8 review to carry out an assessment as if it were for a Standard Authorisation there is no power when carrying out a Part 8 Review assessment to alter the period of the existing Standard Authorisation.

The March 2011 changes to forms 1, 2 and 4 reflect the new registration requirements for the Care Quality Commission and thus the wording in relation to who can sign on behalf of managing authorities has necessarily been changed.

The forms can be adapted but, if used in unedited form they help all those involved in the safeguards processes to fully meet the requirements of the Deprivation of Liberty Safeguards legislation.

Anybody in possession of or still using any earlier drafts of the forms, including those on the CD–Rom published by the Department, is strongly advised to dispose of the PDF versions of any of those earlier forms, as there have been a number of technical improvements made to them since that time, and replace them with and use only the versions currently on these pages.

Other changes made since February 2009 allow users to much more effectively fill out and save the PDFs electronically.

The documents and forms are in both (Rich Text Format (RTF) and Portable Document Format (PDF) formats and in both single continuous documents that contain all the forms and documents and forms that are separated out and available in single file.

The signature boxes cannot be electronically filled in if an RTF format form has been opened in Microsoft Word.

The PDF single forms should allow anybody using Adobe Reader 8 or 9 to electronically complete those forms. Help on viewing PDFs is available elsewhere on this page.

The single form versions in RTF and PDF formats are available in colour and non-colour versions.We are aware that some people have experienced difficulties in scanning and faxing the forms that are coloured blue and green, and so you are strongly advised to use the non colour versions to avoid any difficulties if scanning or faxing.

The colour forms have been designed to print off well as black and white copies so should not present the same difficulties as they may when scanned and / or faxed.

The current PDF forms have been amended to overcome the difficulties previously experienced where the font size automatically reduced. The font size should no longer reduce and a continuation sheet has also been developed to be used where more text needs to added to any text box that has become “full” as the boxes do not expand.

These are standard and not statutory forms but supervisory bodies and managing authorities, and IMCAs, are strongly encouraged to use them as their use will fulfil not only their legal obligations but will bring a nationwide consistency to the implementation of the safeguards.

NB: The Department will not be updating these forms hereafter. Should changes be required, as they are standard and not statutory forms, those changes will need to be made locally.


DH website:

Extract from Welsh Guidance

From 1 April 2009 any care home or hospital treating or caring for a person in such a way that they are depriving that person of their liberty is required to seek authority to do so. Both the “Guidance for Supervisory Bodies” and “Guidance for Managing Authorities” explain the process that must be followed in order to obtain authorisation if there is not already authority given by the court.

This guidance contains information about the recommended forms and letter that may be used in the authorisation process. It should be noted that these forms and letters are not prescribed by statute and are simply suggested documents designed to ensure that the correct processes are followed according to the requirements of the deprivation of liberty safeguards. Whilst there is no legislative requirement to use these standard forms or letters they cover the record-keeping and notice-giving that is required by statute and therefore their use in unedited form will help to ensure compliance with the safeguards and also promote a consistent approach to record-keeping.

Managing authorities, supervisory bodies, and assessors may wish to adapt these forms and letters, to accommodate their own record keeping policies and arrangements.


Wales NHS website:

See also

Deprivation of Liberty Safeguards