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Get CA MH 303 E/S 2004

PATIENT ADVISEMENT (TO BE READ AND GIVEN TO THE PATIENT AT TIME OF ADMISSION) MH 303 E/S (Rev. 08/04) Name of Facility Patient’s Name Admission Date Section 5157 (c) and (d) of the Welfare and Institutions Code requires that each person admitted for 72-hour evaluation be given specific information orally and in writing, and a record of the advisement be kept in the patient’s medical record. My name is _______________________________ My position here is ________________________ You are .

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