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Ndent (OUTPATIENT FAILS TO APPEAR FOR PREHEARING EXAMINATION) G.S. 122C-265(a); 122C-263(f) Date Of First Examination Name Of Examining Physician Or Eligible Psychologist Date Of Missed Appointment Name And Address Of Proposed Outpatient Treatment Physician Or Center Time Of Missed Appointment AM PM NOTE: Use this form only when (1) a physician or eligible psychologist has conducted a first examination at the initiation of an involuntary commitment proceeding and has recommended outpatie.

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