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Get FL CF-MH 3025b 2005

____________________________________ at time _________ am pm (time must be within the preceding 48 hours) on _________/ ________/ 20 ______ in ________________________________ County and that person appears to meet criteria for involuntary examination OR I am a physician who has determined that (printed name of person) ___________________________________ has failed or has refused to comply with the treatment ordered by the court, and, in my clinical judgment, efforts were made to solicit compli.

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