0001209191-24-000231.txt : 20240102 0001209191-24-000231.hdr.sgml : 20240102 20240102183235 ACCESSION NUMBER: 0001209191-24-000231 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20240101 FILED AS OF DATE: 20240102 DATE AS OF CHANGE: 20240102 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Campbell Colleen Rae CENTRAL INDEX KEY: 0002004834 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40199 FILM NUMBER: 24503855 MAIL ADDRESS: STREET 1: C/O GREENBROOK TMS INC. STREET 2: 890 YONGE STREET 7TH FLOOR CITY: TORONTO STATE: A6 ZIP: M4W3P4 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Greenbrook TMS Inc. CENTRAL INDEX KEY: 0001735948 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 000000000 STATE OF INCORPORATION: A6 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 890 YONGE STREET, 7TH FLOOR CITY: TORONTO STATE: A6 ZIP: M4W 3P4 BUSINESS PHONE: 416-322-9700 MAIL ADDRESS: STREET 1: 890 YONGE STREET, 7TH FLOOR CITY: TORONTO STATE: A6 ZIP: M4W 3P4 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2024-01-01 0 0001735948 Greenbrook TMS Inc. GBNH 0002004834 Campbell Colleen Rae C/O GREENBROOK TMS. 890 YONGE STREET 7TH FLOOR TORONTO A6 M4W3P4 ONTARIO, CANADA 1 0 0 0 Common Shares 5000 D Options 10.00 2028-10-03 Common Shares 6000 D Options 10.13 2030-02-03 Common Shares 6000 D Deferred Share Units 0.00 Common Shares 252008 D These options were granted pursuant to the Company's Amended Employee Stock Option Plan (the "Stock Option Plan"), as described in the Company's 2022 Meeting Information Circular, filed with the Securities and Exchange Commission on May 23, 2023. The options were granted on October 3, 2018 and fully vested on March 31, 2019 and accordingly, are all exercisable. These options were granted pursuant to the Stock Option Plan on February 3, 2020 and vested over a three year period, with one-third vesting on each of the 3 anniversaries of the date of the grant. As of the date hereof, all options are vested and exercisable. Converted to USD based on the average daily exchange rate of the Bank of Canada reported on December 29, 2023. Each option may be exercised for a price of $13.40 Canadian dollars. These deferred share units ("DSUs") were granted between June 15, 2021 and December 15, 2023 pursuant to the DSU Plan for non-employee directors, as described in the Company's 2022 Meeting Information Circular, filed with the Securities and Exchange Commission on May 23, 2023. The DSUs immediately vest upon grant, but holders thereof are not entitled to receive a payment in respect of the value of their DSUs until their tenure on the board of directors ceases. The DSUs do not expire. Ms. Campbell will receive a payment in cash at the fair market value of the common shares represented by his or her DSUs generally within ten days of her elected redemption date. Ms. Campbell's elected redemption date will not be earlier than the date she ceases to hold all positions with the Company and will not be later than December 31 of the year following the year in which she ceases to hold all positions with the Company. /s/William Leonard, Attorney-in-Fact 2024-01-02 EX-24 2 attachment1.htm EX-24 DOCUMENT

LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS


	The undersigned hereby constitutes and appoints Bill Leonard, my true and
lawful attorneys-in-fact and agents, each acting alone,
with full powers of substitution, for me and in my name, place and stead, in any
and all capacities, to sign any and all Forms 3, 4 or 5
in connection with my beneficial ownership of securities of Greenbrook TMS Inc.
(the "Company") that may be required of me pursuant to
Section 16 of the Securities Exchange Act of 1934 and the rules and regulations
promulgated thereunder, and to file the same and all other
documents in connection therewith, with the Securities and Exchange Commission,
granting unto said attorneys-in-fact and agents,
each acting alone, full power and authority to do and perform each and every act
and thing requisite and necessary to be done in and
about the premises, as fully to all intents and purposes as I might or could do
in person, hereby ratifying and confirming all that
said attorneys-in-fact and agents, each acting alone, or his substitute, may
lawfully do or cause to be done by virtue hereof.

I declare that any act or thing lawfully done hereunder by my said
attorneys-in-fact and agents shall be binding on myself and my heirs,
legal and personal representatives, and assigns, whether the same shall have
been done before or after my death, or other revocation of
this instrument, unless and until reliable notice thereof shall have been
received by any party who, upon the faith of this instrument,
accepts my said attorneys-in-fact and agents as authorized to represent me.

This power of attorney and the authority of my attorneys-in-fact and agents
hereunder shall not terminate on my disability but shall
remain in full force and effect for so long as I am an officer or director of
the Company and for such time hereafter as may be necessary
to file any such reports.

IN WITNESS WHEREOF, I have hereunto set my hand and seal this 21st day of
December, 2023.

Name: /s/Colleen Campbell
         Colleen Campbell