Get UK Form H3

Form H3 Regulation 4 4 and 5 Mental Health Act 1983 Sections 2 3 and 4 record of detention in hospital To be attached to the application for admission PART 1 Name and address of hospital PRINT full name of patient Complete a if the patient is not already an in-patient in the hospital. Delete the one which does not apply. a The above named patient was admitted to this hospital on / at date of admission to hospital time in pursuance of an application for admission under section state section of the Mental Health Act 1983. b An application for the admission of the above named patient who had already been admitted to this hospital under section state section date and the patient was accordingly treated as admitted for the purposes of the Act from that time. Signed on behalf of the hospital managers PRINT NAME Date continue overleaf PART 2 To be completed only if the patient was admitted in pursuance of an emergency application under section 4 of the Act On I received on behalf of the hospital managers the second medical recommendation in support of the application for the admission of the above named patient. NOTE IF THE PATIENT IS BEING DETAINED AS A RESULT OF A TRANSFER FROM GUARDIANSHIP THE PATIENT S ADMISSION SHOULD BE RECORDED IN PART 2 OF THE FORM G8 WHICH AUTHORISED THE TRANSFER*. a The above named patient was admitted to this hospital on / at date of admission to hospital time in pursuance of an application for admission under section state section of the Mental Health Act 1983. b An application for the admission of the above named patient who had already been admitted to this hospital under section state section date and the patient was accordingly treated as admitted for the purposes of the Act from that time. b An application for the admission of the above named patient who had already been admitted to this hospital under section state section date and the patient was accordingly treated as admitted for the purposes of the Act from that time. Signed on behalf of the hospital managers PRINT NAME Date continue overleaf PART 2 To be completed only if the patient was admitted in pursuance of an emergency application under section 4 of the Act On I received on behalf of the hospital managers the second medical recommendation in support of the application for the admission of the above named patient. Signed on behalf of the hospital managers PRINT NAME Date continue overleaf PART 2 To be completed only if the patient was admitted in pursuance of an emergency application under section 4 of the Act On I received on behalf of the hospital managers the second medical recommendation in support of the application for the admission of the above named patient. NOTE IF THE PATIENT IS BEING DETAINED AS A RESULT OF A TRANSFER FROM GUARDIANSHIP THE PATIENT S ADMISSION SHOULD BE RECORDED IN PART 2 OF THE FORM G8 WHICH AUTHORISED THE TRANSFER*. a The above named patient was admitted to this hospital on / at date of admission to hospital time in pursuance of an application for admission under section state section of the Mental Health Act 1983. b An application for the admission of the above named patient who had already been admitted to this hospital under section state section date and the patient was accordingly treated as admitted for the purposes of the Act from that time. Signed on behalf of the hospital managers PRINT NAME Date continue overleaf PART 2 To be completed only if the patient was admitted in pursuance of an emergency application under section 4 of the Act On I received on behalf of the hospital managers the second medical recommendation in support of the application for the admission of the above named patient. .