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Get AZ ADHS/BHS MH-104 1993-2021

Rmed, hereby requests that admit the person named herein for evaluation. (Evaluation Agency) 1. The undersigned applicant alleges that there is now in the County a person whose name and address are: (Name) (Address) and that s/he believes that the person has a mental disorder and as a result of said mental disorder, is: a danger to self; a danger to others; and that, during the time necessary to complete pre-petition screening under A.R.S. ยงยง 36-520 and 36-521, the person is likely with.

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