Follow the steps to complete your form accurately.

1. Press the 'Get Form' button to access the NC DMH 5-72-19 form. This will open the document in an online format where you can edit and fill out the necessary information.
2. Begin by entering the county information in the designated field at the top of the form. This specifies the area where the respondent is being evaluated.
3. Input the first examination details, including the file number, client record number, respondent's name, date of birth, age, address, city, state, and contact information. Ensure all personal details are accurate.
4. Provide information about the legally responsible person or next of kin, including their name, address, and relationship to the respondent.
5. Detail the petitioner’s information, including their name and relationship to the respondent, as well as their address.
6. Fill out the examination information, specifying the date, time, and location or method of the examination, be it in-person or via telemedicine.
7. Complete Section I by indicating which criteria for commitment apply to the respondent by checking the appropriate boxes based on their mental health or substance abuse status.
8. In Section II, provide a clear description of findings related to the checked criteria, ensuring to include any health screenings or medical evaluations that were conducted.
9. Proceed to fill in Section III where you will recommend a disposition for the respondent, including options for inpatient or outpatient commitment, and provide details of any treatment centers or physicians involved.
10. Finally, ensure to sign the form where indicated and fill in your credentials. Save, download, print, or share the completed form as needed.

Start filling out your NC DMH 5-72-19 form online today for a straightforward processing experience.