Government of Ontario

Office of the Chief Coroner

Case Selection Data Form

Please complete all fields

Place of Death (Address)

1. Was the death all natural?
i.e. was the death entirely due to natural causes without
contribution from a non-natural condition or event


2. Was the death reasonably foreseeable and does the cause
flow logically from a natural disease process?


3. Is there a designated health care practitioner to complete the
Medical Certificate of Death?


4. Is the case free of significant care related concerns from either
family or care providers?


5. Are OCC policy and/or Section 10 (2)(3) statutory obligations

• Child with CAS involvement (direct service in the past 12 months);
• Threshold case for a long term care facility;
• Decomposed body;
• Need for positive identification;
• Deaths in:
a) Charitable institutions
b) Children’s residence under the Child & Family Services Act
c) A supported group living residence under the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act
d) A psychiatric facility under the Mental Health Act
e) An institution under the Mental Hospitals Act
f) A public or private hospital to which the person was transferred from a facility, institution or home referred to in a) to e) above.

Accepted for a Death Investigation? (Criteria – answer “No” to any of questions #1-5, and/or careful consideration of Section 10 criteria)

Declined for Investigation? If yes, inclusion criteria for reporting and payment met?
Electronically submit Case Selection Data Form & Case Selection Invoice to the Regional Supervising Coroner’s Office via Enterprise A ttachment Transfer Service (EATS) or via Fax if EATS is unavailable for payment.