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Get CA DHCS 1808 (formerly MH 1760) 2019-2023

0.15 (ADDITIONAL 30 DAYS INTENSIVE TREATMENT) OF THE WELFARE AND INSTITUTIONS CODE CONFIDENTIAL PATIENT INFORMATION 14 day hold 30 day hold The authorized agency providing 14-day intensive treatment, County of has custody of: Name Address Marital Status Date of Birth Sex We, the undersigned, allege that the above-named person is, as a result of a mental disorder or impairment by chronic alcoholism (mark all that apply): A danger to others A danger to.

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