Get Ga Form 1013 2012-2025

Filling out the GA Form 1013 online is an essential step in authorizing the transport of an individual who may require involuntary mental health treatment. This guide provides clear, step-by-step instructions to ensure users complete the form accurately and efficiently.

Follow the steps to complete the GA Form 1013 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the county where the individual is currently located, not where the Emergency Receiving Facility (ERF) is situated.
3. Enter the name of the individual being examined and the date and time of the evaluation. Ensure the evaluation occurred within 48 hours prior to signing the form.
4. Indicate your professional opinion by checking one or both boxes: 'A' if there is a substantial risk of imminent harm to self or others, and 'B' if the individual is unable to care for their own health and safety.
5. Provide specific observations that support your opinion that the individual appears mentally ill, referencing any overt acts or threats.
6. Check the appropriate boxes indicating any recent threats or acts of violence committed by the individual towards themselves or others.
7. Date and sign the form, ensuring to include your professional credentials (M.D., D.O., Ph.D., LCSW, CNP).
8. After the ERF has agreed to accept the patient, complete the bottom section of the form with the ERF details.
9. Fill out the Report of Peace Officer or Other Person Providing Transportation section, starting with the county where the transport occurred.
10. Document the name of the individual transported, the ERF name, time and date of pick-up, location, and observations made during transport.
11. Include details about any family or other individuals present at the time of custody, noting their comments or knowledge about the individual.
12. Indicate if any physical restraints were used during transportation and provide justifications for their use.
13. Comment on the individual's physical condition, noting any apparent injuries or distress observed.
14. Indicate who provided the transportation and ensure the form is signed and dated before delivering it to the ERF.

Complete and submit the GA Form 1013 online to ensure the proper care and evaluation of individuals in need.