Free pcm244.pmd - Michigan

Approved, SCAO

JIS CODE: OFN

STATE OF MICHIGAN ORDER FOLLOWING NOTICE OF NONCOMPLIANCE WITH ASSISTED OUTPATIENT TREATMENT OR PROBATE COURT COMBINED HOSPITALIZATION AND ASSISTED COUNTY OUTPATIENT TREATMENT ORDER CIRCUIT COURT - FAMILY DIVISION In the matter of 1. Date of hearing (if one): 2. This court issued an order on
Date

FILE NO.

Judge:
Bar no.

directing the individual named above to undergo a program of

assisted outpatient treatment or combined hospitalization and assisted outpatient treatment. 3. The court has been notified that the individual is not complying with the order for assisted outpatient treatment or combined hospitalization and assisted outpatient treatment. 4. THE COURT FINDS:

IT IS ORDERED: 5. A peace officer shall take the individual into protective custody and transport the individual to the preadmission screening unit established by the community mental health services program serving the community in which the individual resides. .
Designated facility

6. The individual shall be hospitalized at for a period of not more than 10 days. If necessary, a peace officer shall take the individual into protective custody. as recommended by the community mental health services program, more than 10 days but not more than the duration of the order for assisted outpatient treatment or 90 days, whichever is less. If necessary, a peace officer shall take the individual into protective custody. 7. The individual may return to assisted outpatient treatment before the expiration of the prior order of assisted outpatient treatment or combined hospitalization and assisted outpatient treatment as follows:
Date Judge

NOTICE OF RIGHT TO OBJECT TO HOSPITALIZATION This court has ordered you to be hospitalized. You have a right to object to this hospitalization. If you wish to object, complete the objection below and send a copy to the court. PROOF OF SERVICE I certify that this notice was personally served on the above individual on and a copy mailed to the
Signature Date

at
Time

Court on
Date

.

OBJECTION TO HOSPITALIZATION I object to my hospitalization and request that the court schedule a hearing on the objection.

Date

Signature

Do not write below this line - For court use only

MCL 330.1475(3), (4), (5), (6), MCR 5.744 PCM 244 (9/07) ORDER FOLLOWING NOTICE OF NONCOMPLIANCE WITH ASSISTED OUTPATIENT TREATMENT OR

COMBINED HOSPITALIZATION AND ASSISTED OUTPATIENT TREATMENT ORDER