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Documents used along the form

The PCM 209 Michigan form is an important document in the context of mental health proceedings. It is often used in conjunction with several other forms and documents, each serving a specific purpose in the process of hospitalization and examination. Below is a list of these related documents, along with brief descriptions of their functions.

  • PCM 201 - Application for Hospitalization: This form initiates the process for seeking hospitalization for an individual. It outlines the reasons for the request and provides necessary details about the individual in question.
  • PCM 202 - Petition for Emergency Hospitalization: This document is used to request immediate hospitalization for an individual who poses a danger to themselves or others. It emphasizes the urgency of the situation.
  • PCM 204 - Order for Examination: This form is issued by the court to authorize a mental health examination of the individual. It specifies the details regarding where and when the examination should take place.
  • PCM 205 - Report of Examination: After the examination is conducted, this report is completed by the examining physician or psychologist. It provides findings and recommendations based on the individual's mental health status.
  • Minnesota Promissory Note - A crucial document for securing loans, ensuring thorough understanding of payment terms and conditions. For more details, visit promissoryform.com/blank-minnesota-promissory-note.
  • PCM 206 - Petition for Involuntary Hospitalization: This document is filed when there is a need to seek court-ordered hospitalization against the individual's will. It includes evidence supporting the necessity of such action.
  • PCM 207 - Notice of Hearing: This form is used to inform involved parties about the scheduled hearing regarding the hospitalization petition. It ensures that all relevant individuals are aware of the proceedings.
  • PCM 208 - Order for Protective Custody: This order allows law enforcement to take an individual into protective custody when there is an immediate need for intervention due to mental health concerns.
  • PCM 210 - Consent for Treatment: This document is used to obtain consent from the individual or their legal representative for treatment following hospitalization. It outlines the treatment plan and any associated risks.

Understanding these documents is crucial for anyone involved in the mental health legal process in Michigan. Each form plays a distinct role in ensuring that individuals receive the necessary care and protection while also respecting their legal rights. Familiarity with these documents can help navigate the complexities of mental health proceedings more effectively.

Pcm 209 Michigan Preview

Approved, SCAO

JIS CODE: SPA

STATEOFMICHIGAN PROBATECOURT COUNTYOF

SUPPLEMENTAL PETITION TO

APPLICATION FOR HOSPITALIZATION

AND ORDER FOR EXAMINATION

FILE NO.

In the matter of

PETITION

1.I executed the attached Application for Hospitalization (PCM 201). I have been unable to have the individual examined by a physician or licensed psychologist although I have made the following efforts:

2.I request the court to order

a.the individual to be examined at

the preadmission screening unit designated by the community mental health services program.

b. a peace officer to take the individual into protective custody and transport him/her to the preadmission screening unit named above for the examination.

I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief.

Date

Attorney name (type or print)

Bar no.

 

 

Address

 

 

 

City, state, zip

Telephone no.

Signature of petitioner

Name (type or print)

Address

City, state, zip

 

 

 

 

 

 

ORDER

 

 

 

THE COURT FINDS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. The application

is

is not

reasonable and in full compliance with section 424 of the Mental Health Code.

4. A reasonable effort

was

was not

made to secure an examination.

 

 

5.

It is necessary that a peace officer take the individual into protective custody and immediately transport him or her to the

 

designated preadmission screening unit for the examination.

 

 

6.

There does not appear to be probable cause to take action on this petition.

 

 

IT IS ORDERED:

 

 

 

 

 

 

 

 

7.

The individual be examined at the designated preadmission screening unit.

 

 

8.

A peace officer shall take the individual into protective custody and immediately transport him or her to the designated

 

preadmission screening unit provided that the individual is presented for examination by

 

,

 

which is within 10 days of the date of execution of the application.

Date

9.

The petition is denied.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

Judge

Bar no.

USE NOTE: If this form is being filed in the circuit court family division, please enter the court name and county in the upper left-hand corner of the form.

Do not write below this line - For court use only

MCL 330.1428, MCL 330.1429

PCM 209 (9/13) SUPPLEMENTAL PETITION TO APPLICATION FOR HOSPITALIZATION AND ORDER FOR EXAMINATION

Similar forms

  • PCM 201 - Application for Hospitalization: This form initiates the request for an individual to be hospitalized due to mental health concerns. It serves as the foundational document that the PCM 209 builds upon, detailing the need for examination.
  • PCM 202 - Petition for Appointment of a Guardian: Similar to PCM 209, this document seeks court intervention for an individual’s well-being, focusing on appointing a guardian when the individual is unable to care for themselves.
  • Living Will Form: For expressing healthcare wishes, review our comprehensive Living Will form guidelines to ensure your preferences are documented accurately.
  • PCM 203 - Petition for Appointment of a Conservator: This form requests the court to appoint a conservator to manage the financial affairs of an individual who is unable to do so, paralleling the protective custody aspect of PCM 209.
  • PCM 204 - Petition for Mental Health Treatment: This document is used to request court-ordered mental health treatment, similar in intent to PCM 209, which seeks examination and potential treatment for an individual.
  • PCM 205 - Petition for Involuntary Hospitalization: This form specifically requests the court to order involuntary hospitalization, directly aligning with the goals of the PCM 209 for examination and potential hospitalization.
  • PCM 206 - Petition for Emergency Hospitalization: This document is used in urgent situations where immediate hospitalization is necessary, akin to the immediate action requested in the PCM 209.
  • PCM 207 - Order for Examination: This form is a court order directing an examination of an individual, similar to the examination request in the PCM 209.
  • PCM 208 - Notice of Hearing: This document informs parties involved of a hearing related to mental health proceedings, ensuring transparency and communication, much like the procedural aspects of PCM 209.
  • PCM 210 - Report of Examination: Following the examination, this form documents the findings and recommendations, providing essential information for subsequent actions, similar to the outcomes sought in PCM 209.

Misconceptions

Understanding the PCM 209 Michigan form is crucial for anyone involved in mental health legal proceedings. However, several misconceptions can cloud the actual purpose and use of this form. Here’s a list of common misunderstandings:

  • The PCM 209 is a standalone form. Many believe it can be used independently, but it is actually a supplemental petition that requires an accompanying Application for Hospitalization (PCM 201).
  • Only attorneys can file the PCM 209. While it is common for legal representation to assist, individuals can also file the form themselves if they meet the necessary criteria.
  • The form guarantees hospitalization. Submitting the PCM 209 does not ensure that the court will approve hospitalization; it merely requests an examination.
  • The process is quick and straightforward. In reality, the process can take time, and several steps must be completed before any action is taken.
  • All petitions are approved. Many assume that if they file the form, the court will always grant the request. However, the court may deny the petition if it finds insufficient grounds.
  • Anyone can request a protective custody order. Only individuals with a legitimate concern for the person's safety and well-being can make this request through the form.
  • The form is only for severe cases. Some think it’s only applicable in extreme situations, but it can be used for any case where an individual may need evaluation for mental health issues.
  • Filing the form is the end of the process. After filing, there may be additional hearings or requirements that need to be addressed before a final decision is made.
  • Completing the form is simple. While the form may seem straightforward, it requires careful attention to detail and understanding of the legal implications involved.
  • Once filed, the form cannot be changed. Petitioners can amend their filings if new information or circumstances arise that warrant changes.

Being aware of these misconceptions can help individuals navigate the complexities of the PCM 209 form more effectively.

Detailed Instructions for Using Pcm 209 Michigan

Filling out the PCM 209 Michigan form is an important step in the legal process regarding hospitalization. This form requires careful attention to detail. Follow these steps to ensure you complete it correctly.

  1. Begin by entering the county name in the upper left-hand corner of the form.
  2. Fill in the file number in the designated space.
  3. In the section labeled "In the matter of," write the name of the individual involved.
  4. Complete the first statement by checking the box indicating you executed the attached Application for Hospitalization (PCM 201).
  5. List the efforts you made to have the individual examined by a physician or licensed psychologist.
  6. In the next section, check the box for either: a. requesting the court to order the individual to be examined at the designated preadmission screening unit, or b. requesting a peace officer to take the individual into protective custody.
  7. Sign and date the petition at the bottom of the form.
  8. Type or print your name, address, city, state, zip code, and telephone number in the designated spaces.
  9. If you are an attorney, include your name, bar number, and address as well.

After completing the form, review it to ensure all information is accurate. This will help avoid delays in processing your petition.

Dos and Don'ts

When filling out the Pcm 209 Michigan form, it is essential to approach the process with care and attention to detail. Here’s a list of things you should and shouldn’t do to ensure your submission is accurate and effective.

  • Do read the instructions thoroughly before starting the form.
  • Do provide complete and accurate information about the individual in question.
  • Do include your contact information, ensuring it is up to date.
  • Do clearly state the efforts you made to secure an examination.
  • Do ensure that the petition is signed and dated appropriately.
  • Don't leave any sections of the form blank; this could delay processing.
  • Don't use legal jargon or overly complex language; clarity is key.
  • Don't forget to check for spelling and grammatical errors.
  • Don't submit the form without reviewing it multiple times.
  • Don't ignore the specific requirements for filing in the circuit court family division.

By following these guidelines, you can help ensure that your Pcm 209 Michigan form is filled out correctly, facilitating a smoother process in the court system.