Free pcm223.pmd - Michigan


File Size: 16.9 kB
Pages: 1
Date: February 15, 2008
File Format: PDF
State: Michigan
Category: Court Forms - State
Author: GentilozziT
Word Count: 184 Words, 1,137 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://courts.michigan.gov/scao/courtforms/mentalhealth/pcm223.pdf

Download pcm223.pmd ( 16.9 kB)


Preview pcm223.pmd
Approved, SCAO

JIS CODE: CLC/WOA

STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION

FILE NO. CERTIFICATE OF LEGAL COUNSEL / WAIVER OF ATTENDANCE

In the matter of

CERTIFICATE OF LEGAL COUNSEL 1. I have been appointed by the court as legal counsel for the individual named above. 2. A hearing on the petition for admission/hospitalization/assisted outpatient treatment has been set as follows: Date: Time: Location: Judge: 3. I certify that I personally have seen and consulted with the individual at least 24 hours before the time set for the hearing.

Date

Signature of attorney Attorney name (type or print) Address City, state, zip

Bar no.

Telephone no.

WAIVER OF ATTENDANCE I understand that it is my right to be present at the hearing on the petition for admission/hospitalization/assisted outpatient treatment set for the date stated above but I waive that right.

Date

Signature of the individual named above

Witness:
Signature of legal counsel

Do not write below this line - For court use only

PCM 223 (9/07)

CERTIFICATE OF LEGAL COUNSEL / WAIVER OF ATTENDANCE

MCL 330.1454(1), MCL 330.1455(1)