1.7. The psychosocial assessment report necessary for temporary representation of the incapable person of full age must contain(1) the identification of the person of full age, namely, the person’s name, commonly used name, date of birth, gender, health insurance number, address, e-mail address, if any, telephone number, the names of the person’s parents, the person’s legal status and, if applicable, the name of the Aboriginal community to which the person belongs, civil status and, as the case may be, the name of the person’s spouse, if any;
(2) the circumstances giving rise to the application for assessment, the applicant’s name and relationship to the person of full age;
(3) a description of the act for which the person of full age needs temporary representation and the relevant information pertaining to the act;
(4) the date of each examination conducted by the assessor, the identification of each person consulted, namely, the person’s name, relationship to the person of full age, telephone number, date of consultation and identification of the relevant documents consulted by the assessor and referred to in the assessor’s report;
(5) a summary description of the psychosocial situation of the person of full age;
(6) a description of the need for temporary representation of the person of full age and the impact of the incapacity of the person of full age on accomplishment of the specific act;
(7) the name of the person who wishes to be designated as the temporary representative and relationship to the person of full age;
(8) the opinion of the person of full age concerning the application for temporary representation, the person proposed to act as the temporary representative, as well as the wishes and preferences of the person of full age concerning the act to be performed;
(9) the names of the relatives, persons connected by marriage or a civil union, or friends of the person of full age who have been consulted and their respective opinions respecting the application for temporary representation and the person proposed to act as temporary representative;
(10) the name of the relative, person connected by marriage or a civil union, or friend of the person of full age who would agree to receive the account of the temporary representative, where applicable;
(11) the opinion of the assessor as regards the incapacity of the person of full age, the temporary and circumscribed nature of the need for representation and the person proposed to act as temporary representative;
(12) the identification of the special needs of the person of full age in the event that it is necessary to interview the person;
(13) the identification of the person responsible for the psychosocial follow-up of the person of full age, namely, the person’s name, profession, place of practice and telephone number; and
(14) the identification of the assessor, namely, the assessor’s name, professional permit number, professional address, e-mail address and telephone number.