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California Physician's Request to Continue Medication - Attachment

State:
California
Control #:
CA-JV-220B
Format:
PDF
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Description

The doctor uses this to request a court order for a continuing prescription of psychotropic medication. It is a shorter version of form JV-220A and may be used only by the same doctor who filled out the most recent JV-220A if they are prescribing the same medication with the same maximum dosage.

California Physician's Request to Continue Medication — Attachment is a form used in the state of California to allow a physician to request the continuation of a patient’s medication. It is typically used when the patient’s prescription is about to expire and the physician wants to extend the prescription period. The form is typically filled out by a physician and submitted to the patient’s health insurance provider. It includes the patient's information, physician's information, medication name and dosage, and the patient's diagnosis. There are two types of California Physician's Request to Continue Medication — Attachment: Form A and Form B. Form A is used when the patient is insured through an HMO, while Form B is used when the patient is insured through a non-HMO provider.

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FAQ

An initial request to administer psychotropic medication to this child. A request to start a new medication or to increase the maximum dose of a previously approved medication. 3. This application is made during an emergency situation as defined in California Rules of Court, rule 5.640(i).

JV-220 Application For Psychotropic Medication.

If the applicant is the social worker or probation officer, he or she must complete all items on form JV-220. If the applicant is the prescribing physician, medical office staff, or child's caregiver, he or she must complete and sign only page one of form JV-220.

(6) Application for Psychotropic Medication (form JV-220) may be completed by the prescribing physician, medical office staff, child welfare services staff, probation officer, or the child's caregiver.

Lists the courts findings and orders about the child's psychotropic medications. The social worker or probation officer must provide a copy of the form to the child's caregiver.

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California Physician's Request to Continue Medication - Attachment