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Approved SCAO STATE OF MICHIGAN PROBATE COURT COUNTY OF JIS CODE SPA SUPPLEMENTAL PETITION TO APPLICATION FOR HOSPITALIZATION AND ORDER FOR EXAMINATION FILE NO. In the matter of PETITION 1. I executed the attached Application for Hospitalization PCM 201. I have been unable to have the individual examined by a physician or licensed psychologist although I have made the following efforts 2. Approved SCAO STATE OF MICHIGAN PROBATE COURT COUNTY OF JIS CODE SPA SUPPLEMENTAL PETITION TO APPLICATION FOR HOSPITALIZATION AND ORDER FOR EXAMINATION FILE NO. In the matter of PETITION 1. I executed the attached Application for Hospitalization PCM 201. I have been unable to have the individual examined by a physician or licensed psychologist although I have made the following efforts 2. I request the court to order a* the individual to be examined at the preadmission screening unit designated by the community mental health services program* b. a peace officer to take the individual into protective c....

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How to fill out the Pcm 201 online

The Pcm 201 is a crucial form used in the mental health process for hospitalization applications. Properly filling out this document is essential to ensure that the appropriate actions are taken regarding the individual's mental health evaluation and care.

Follow the steps to fill out the Pcm 201 form online

  1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the court county name in the designated space provided at the top of the form.
  3. Input the case file number in the specified field, ensuring that all references are accurate.
  4. In the petition section, include your full name as the petitioner and specify the name of the individual who requires hospitalization.
  5. Detail the efforts made to secure an examination by a physician or licensed psychologist in the space provided.
  6. Select the appropriate options regarding the request to the court, including whether to order an examination at the designated unit and protective custody by a peace officer.
  7. Carefully review all entries for accuracy, ensuring that your declaration is signed and dated.
  8. Provide your attorney's name, bar number, address, and contact information if applicable.
  9. Upon completion, you can save your changes, download the form, print it, or share it as necessary.

Complete your Pcm 201 form online today for a seamless submission process.

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The clinical certificate certifies that the individual personally examined is mentally ill and a person requiring treatment. The first certificate can be executed by any physician or licensed psychologist and is good for up to 72 hours prior to hospitalization.

This order may be valid for up to 15 months during which time you will receive psychiatric treatment.

Court staff will tell you to come to fill out a petition and submit it by email to: mentalhealth@wcpc.us. You will need to describe in writing: 1. What specific symptoms and behaviors the person is displaying.

Individual may be detained for 24 hours for such examination. If physician or psychologist will not certify, the Court may dismiss or order examination by a psychiatrist if available. If not available, it may order examination by physician or psychologist.

File your petition via email to: mentalhealth@wcpc.us; indicate “Emergency” in the subject line. i. Once your petition is processed you will be sent hearing information, including ZOOM instructions. ii.

This order may be valid for up to 15 months during which time you will receive psychiatric treatment.

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