Provincial Court

EPO Forms

PDF Note: The following links are PDFs and will open in a new window.


Completed by police or lawyers when faxing applications to court.

Fax Cover Sheet


To be completed by the applicant and/or signed by applicant confirming the contents of the application.

Appendix: lists all the conditions the Court may put in an EPO. Review the list and check off the conditions you would like the Court to consider.

Application for Emergency Protection Order


Applicant must swear to the information in Form 3.

Form 002, 003, and the Appendix make up the application for an EPO. They are completed by the applicant if they are applying for an EPO on their own at Court OR by police or lawyers if they are applying for an EPO on behalf of a victim.

Evidence In Support Of Application For A Protection Order


Completed by the court if the Order is granted.

Emergency Protection Order


Application for Substitute Service/Dispense with Service

Application for Substitute Service Dispense with Service


Sworn Statement In Support Of Application For Substituted/Dispensing With Service

Form 005 and 006 are completed by the police if they need permission from the Court to serve the order other than in person.

Sworn Statement In Support Of Application For Substituted/Dispensing With Service


Completed by the respondent if they want a review hearing in Court and/or completed by any party (applicant or respondent) seeking a change of the EPO.



Completed by the police for the Court confirming they have served the EPO granted and how it was served.

Affidavit Of Service


Completed by either the applicant or respondent in an EPO case who wishes to call witnesses to a hearing.

Application For Leave To Call Witness(es)


If an application is made to review an EPO, the other party may reply with this form. There is no requirement to reply but a person may reply if they wish.



Completed by the Court to notify parties of scheduled hearing dates.

Notice Of Hearing


Completed by an applicant in a review or variation process if they wish to disregard the application.

Notice Of Abandonment