Free Pcm 209 Michigan Template Prepare Document Here

Free Pcm 209 Michigan Template

The PCM 209 Michigan form is a legal document used in the state of Michigan, designed to supplement an Application for Hospitalization, specifically when initial efforts to have an individual examined by a physician or licensed psychologist have failed. It requests the court to order an examination at a designated preadmission screening unit or to have a peace officer transport the individual to such a facility for examination. If you or someone you know needs to facilitate this critical step toward obtaining necessary mental health services, clicking the button below will guide you through the process of accurately filling out and submitting the PCM 209 Michigan form.

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In the intricate landscape of mental health care and legal intervention in Michigan, the PCM 209 form emerges as a crucial document designed to navigate the challenging process of hospitalization for individuals unable to consent to treatment due to their mental state. This Supplemental Petition to Application for Hospitalization and Order for Examination serves as a bridge when initial attempts to secure a voluntary examination of an individual by a physician or licensed psychologist have failed. It meticulously outlines a petitioner's efforts to have the individual examined and requests judicial intervention to ensure the individual's assessment by a designated preadmission screening unit. Moreover, it empowers peace officers to take individuals into protective custody for immediate transport to the screening unit, emphasizing the state's commitment to both individual welfare and public safety. The form's dual focus on detailed reporting of prior attempts at voluntary examination and the clear pathway it lays out for compulsory examination reflects a careful balancing of individual rights with the need to address mental health crises decisively. With its sections filled out under the penalties of perjury, the PCM 209 not only underscores the gravity of the mental health situation at hand but also the legal responsibilities of all parties involved, from petitioners to law enforcement, to operate within the framework established by Michigan's Mental Health Code. As such, the PCM 209 form is a testament to Michigan's legal system's efforts to provide a structured, humane response to complex mental health challenges.

Sample - Pcm 209 Michigan Form

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

File Details

Fact Name Description
Form Title Supplemental Petition to Application for Hospital.DynamicResize DynamicResizeization and Order for Examination
Form Number PCM 209
Approval Status Approved by SCAO
Jurisdiction Michigan Probate Court
Relevant Law Mental Health Code, specifically sections MCL 330.1428 and MCL 330.1429
Purpose of Form To request a court order for an individual to be examined by a physician or licensed psychologist at a preadmission screening unit when prior attempts have been unsuccessful.
Key Components Details efforts made to secure an examination, requests for a court-ordered examination, and demands for protective custody and transport by a peace officer if necessary.
Declaration Requirement The petitioner must declare under penalties of perjury that the information provided in the petition is true to the best of their knowledge.
Outcome Options The court may find the application reasonable and comply with the law, may order the individual to be examined, may require a peace officer to transport the individual for examination, or may deny the petition.

Pcm 209 Michigan - Usage Steps

Filing the PCM 209 form in Michigan is crucial for requesting a court order for an individual's examination when previous attempts have been unsuccessful. This supplementary petition is typically filed after an initial application for hospitalization (PCM 201) lacks the necessary examination by a physician or licensed psychologist due to various reasons. This process ensures that those in need of mental health services are assessed by professionals in a timely manner. The following steps provide a guide to accurately completing the PCM 209 form:

  1. Start by entering the full legal name of the individual in question at the top where it says "In the matter of."
  2. Fill in the "File No." with the case number associated with the initial PCM 201 application.
  3. In section 1, note that you have executed the attached Application for Hospitalization (PCM 201). Also, describe the efforts you've made to have the individual examined by a professional.
  4. In section 2, indicate your request to the court. Tick the appropriate box whether you're asking for:
    • The individual to be examined at the designated preadmission screening unit.
    • A peace officer to take the individual into protective custody and transport them to the preadmission screening unit for the examination.
  5. Under the declaration statement, enter the current date to affirm the accuracy and truthfulness of the information provided in the petition.
  6. Provide the attorney's name, bar number, and contact information, including address and telephone number, in the designated areas if an attorney is involved. If you're filling the form out on your own, you may leave these sections blank.
  7. Sign your name under "Signature of petitioner" and then print your name, address, city, state, and zip code below.
  8. If completing the form for use in the circuit court family division, remember to enter the court name and county in the upper left-hand corner, as instructed in the Use Note.

Once the form is completed and reviewed for accuracy, it should be submitted to the appropriate Michigan Probate Court. Following submission, the court will assess the petition and, if found reasonable and compliant with the Mental Health Code, will issue an order for the designated actions, such as examination or protective custody, to be carried out. It's important to follow up with the court to understand the progress of your petition and any next steps required from your side.

Learn More on This Form

What is the PCM 209 Michigan form?

The PCM 209 Michigan form, known as the Supplemental Petition to Application for Hospitalization and Order for Examination, is a legal document used in the state of Michigan. It supplements an initially filed Application for Hospitalization (PCM 201) when the petitioner has been unable to secure an examination by a physician or licensed psychologist for an individual, despite making efforts to do so. This form requests the court to intervene in facilitating the necessary examination to proceed with hospitalization under specific circumstances.

Who needs to fill out the PCM 209 Michigan form?

This form is utilized by petitioners who have already submitted a PCM 201 Application for Hospitalization on behalf of an individual believed to require mental health hospitalization but have not been successful in having the individual examined by a qualified professional. Typically, petitioners are family members, legal guardians, or mental health professionals acting in the interest of someone whose condition necessitates court-ordered evaluation and possibly, hospitalization.

What steps need to be taken before filing the PCM 209 form?

Before filing a PCM 209 form, the petitioner must attempt to have the individual in question examined by a physician or licensed psychologist. The form specifically requires documentation of the efforts made to secure such an examination, indicating that it is a measure of last resort after other attempts have failed.

How does one file the PCM 209 Michigan form?

Filing the PCM 209 form involves submitting it to the probate court in the county where the individual resides or where the individual is present. It must be accompanied by the previously filed PCM 201 Application for Hospitalization. The court then reviews the supplemental petition to decide on the necessity of court-ordered examination and any subsequent actions.

What happens after the PCM 209 form is filed?

Upon filing, the court will review the petition and determine:

  1. Whether the application complies with Section 424 of the Mental Health Code.
  2. If reasonable efforts were made to secure an examination.
  3. Whether it is necessary for a peace officer to take the individual into protective custody for immediate transport to a preadmission screening unit for examination.
The judge's order will follow, based on these findings, directing the next steps in the examination and hospitalization process.

What are the possible outcomes once the PCM 209 is submitted?

The court can decide in several ways upon reviewing the supplemental petition. The outcomes include:

  • Ordering the examination to take place at the designated preadmission screening unit.
  • Authorizing a peace officer to take the individual into protective custody for transportation to the examination.
  • Denial of the petition if the court finds no probable cause or if the application does not meet the necessary legal standards.
Each decision is aimed at ensuring the individual's needs are adequately addressed in accordance with the law.

What is the significance of the court's findings listed on the form?

The court's findings on the PCM 209 form serve as a legal determination of the necessity and appropriateness of court-ordered examination and potential hospitalization. They verify whether the application aligns with the Mental Health Code, if efforts to secure a voluntary examination were sufficient, and if compelling the individual's examination through court order is justified. These findings are critical in protecting the rights of the individual while addressing public safety and health concerns.

Can the decision of the court be appealed?

Yes, decisions made by the court based on the PCM 209 can be appealed. Individuals who disagree with the court's ruling have the right to seek a review of the decision. The process for appealing will depend on the specific procedures of the Michigan court system, and it might be advisable to consult with a legal professional for guidance on how to proceed.

Where can one find the PCM 209 Michigan form?

The PCM 209 Michigan form is available at Michigan probate courts or can be downloaded from websites hosting Michigan legal forms. It's important to use the most current version of the form and to verify that it is the correct document by checking with your local probate court or consulting with a legal professional specialized in mental health law in Michigan.

Common mistakes

Filling out legal forms requires attention to detail and a deep understanding of the process. When dealing with the PCM 209 Michigan form, which is a Supplemental Petition to Application for Hospitalization and Order for Examination, there are common pitfalls that can hinder the process. Being aware of these mistakes can help ensure that the request is processed smoothly and efficiently.

One common mistake is not providing detailed efforts made to have the individual examined. The form explicitly asks petitioners to list the efforts they have made to get the individual examined by a physician or licensed psychologist. Simply stating that efforts were made without giving any details can lead to the petition being delayed or even denied. It's crucial to list specific actions taken, such as dates and times of attempted appointments or communications with health professionals.

Another error involves incorrect or incomplete information about the designated preadmission screening unit. This request is fundamental to the petition, as it requires the court to understand where and how the examination should be conducted. Petitioners need to ensure that the name and address of the unit are accurately provided. Furthermore, if requesting a peace officer's involvement, it's essential to correctly indicate this in the petition to avoid confusion or unnecessary delays.

Failure to accurately declare the statement under the penalties of perjury is a serious mistake. This section serves as a legal affirmation that the contents of the petition are true and correct to the best of the petitioner's knowledge. Any inaccuracies, intentional or not, can have legal repercussions. It's important to review this declaration thoroughly before signing and dating the document.

Last but not least, overlooking the court's findings and order section can lead to misunderstandings about the process. Although the petitioner might not fill out this section, being aware of what the court will determine based on the petition can provide valuable insights. Understanding that the court will assess whether a reasonable effort was made to secure an examination and whether there is probable cause for action can prepare petitioners for possible outcomes and next steps.

  • Not detailing efforts made for an examination.
  • Providing incorrect information about the preadmission screening unit.
  • Inaccurate declaration under the penalties of perjury.
  • Overlooking the significance of the court's findings and order section.

By avoiding these common mistakes, individuals submitting the PCM 209 form in Michigan can improve their chances of a favorable outcome. It is always advisable to carefully review each section of the form, provide precise and accurate information, and understand the legal implications of the petition being filed.

Documents used along the form

When navigating the complexities of mental health law in Michigan, specifically regarding the hospitalization and treatment of individuals, the PCM 209 Michigan form, known as the Supplemental Petition to Application for Hospitalization and Order for Examination, plays a crucial role. This document is one piece of a larger puzzle, often accompanied by various other forms and documents to ensure a comprehensive legal process. Understanding each document’s purpose can help streamline the process and make sure all legal requirements are fulfilled.

  1. PCM 201 - Application for Hospitalization: The foundational document that precedes PCM 209, it is a formal request to the court for the hospitalization of an individual believed to require mental health treatment. It outlines the initial reasons why hospitalization is deemed necessary.
  2. PCM 202 - Certificate of Need for Hospitalization: This document is completed by a physician or licensed psychologist, providing medical evidence that supports the need for the individual’s hospitalization. It is a critical piece confirming the necessity of treatment from a medical standpoint.
  3. PCM 217 - Order for Hospitalization: Issued by the court, this order authorizes the hospitalization of the individual named in the application. It is the legal document that enables the enforcement of the hospitalization request, following a judge's approval.
  4. PCM 220 - Notice of Rights: When an individual is being considered for hospitalization, this document provides them with an explanation of their legal rights throughout the process. It ensures that the person understands their rights to legal representation, to a hearing, and to object to the hospitalitoization.
  5. Mental Health Treatment Plan: While not a PCM form, the treatment plan is a document typically required to outline the specific mental health services and supports that will be provided to the individual. It is prepared by mental health professionals involved in the case.
  6. Physician’s or Psychologist’s Report: Similar to the Certificate of Need for Hospitalization, this report offers detailed insights into the individual's condition, treatments attempted, and the reasons why hospitalization is recommended. While it might be part of the PCM 202, it can also stand as a separate, detailed medical account.

Together, these forms and documents contribute to a lawful and comprehensive process for the hospitalization of individuals in need of mental health treatment. By ensuring that all steps of the process are documented and that the rights of the individual are protected, the legal system aims to provide a balance between necessary treatment and personal liberties. Understanding the function and importance of each document can assist all parties involved – from family members to legal professionals – in navigating the process more effectively.

Similar forms

The PCM 209 Michigan form is similar to other legal documents that are used in the mental health and judicial system. These documents serve as tools for requesting court interventions in situations where an individual's mental health necessitates evaluation or treatment that cannot be voluntarily obtained. The primary similarity lies in their legal purpose, structure, and the process they initiate within the probate court system. Specifically, the PCM 209 form shares commonalities with the PCM 201 form, Petition for Mental Health Treatment forms, and applications used in emergency situations for protective custody or treatment.

1. PCM 201 - Application for Hospitalization: This document is closely related to the PCM 209 form. It is the initial step for seeking hospitalization for an individual, providing detailed information about the individual's mental health status and the efforts made to seek voluntary treatment. The PCM 209 form acts as a supplemental petition when the initial Application for Hospitalization does not lead to a voluntary examination. Both forms are part of a legal process designed to ensure that individuals who cannot seek help on their own due to their mental state can receive the necessary evaluation and care, with the court's assistance.

2. Petition for Mental Health Treatment: These forms, while not identical, share the goal of facilitating mental health treatment through legal means. Typically used to request formal evaluation and treatment orders from a court, these petitions are necessary when a person is believed to require mental health services but may be unwilling or unable to consent voluntarily. Much like the PCM 209, these documents necessitate the submission of detailed information about the individual's condition and the necessity for court-mandated treatment, highlighting efforts made to obtain consent or the reasons such efforts would not be effective or feasible.

3. Applications for Emergency Protective Custody: In urgent situations where an individual poses a threat to themselves or others due to their mental state, applications for emergency protective custody are utilized. Although these documents initiate a more immediate action than the PCM 209, the underlying principle is the same: to provide protection and necessary medical evaluation to individuals who are not in a state to seek help on their own. These forms require descriptions of the individual's behavior and mental condition, similar to the detailed information required in the PCM 209, ensuring that courts and law enforcement have sufficient context to act promptly and appropriately.

Dos and Don'ts

When filling out the PCM 209 form in Michigan, which is a supplemental petition to an application for hospitalization and order for examination, there are several protocols individuals should follow to ensure the document is correctly completed and submitted. Handling such sensitive information requires attention to detail, adherence to procedural requirements, and a comprehensive understanding of the implications of your request.

Things you should do:

  1. Provide accurate and complete information: Ensure that all information provided on the PCM 209 form is true and accurate to the best of your knowledge. Include detailed efforts made to have the individual examined by a physician or licensed psychologist, as this can influence the court’s decision.
  2. Examine the document before signing: Carefully review the petition for any errors or omissions. The declaration under the penalties of perjury signifies that you have personally examined the petition and attest to the truthfulness and completeness of its contents.
  3. Include supportive documentation: Attach any relevant documents or evidence that support your petition. This might include previous applications, detailed accounts of efforts made to secure an examination, and any other corroborative evidence.
  4. Consult with an attorney: If possible, obtaining legal advice can be crucial. An attorney specialized in mental health law can provide guidance, ensuring that the petition is properly filled out and that you are following the correct legal process.

Things you shouldn't do:

  • Leave sections incomplete: Do not skip any sections or leave blanks on the form. If a section does not apply, clearly mark it as "N/A" (not applicable). Incomplete forms may be rejected or delay the process.
  • Submit without reviewing: Avoid submitting the petition without thorough review. Mistakes or inaccuracies can lead to the denial of the petition or result in legal complications.
  • Provide misleading information: Intentionally providing false information on the PCM 209 can result in perjury charges or other legal consequences. Honesty is paramount when filling out any legal document, especially in matters affecting another person's well-being and rights.
  • Delay submission: Once the form is complete, submit it in a timely manner. Delays can impact the well-being of the individual in question and may affect the legal outcome. The document mentions that the individual must be presented for examination within 10 days of the execution of the application, highlighting the importance of prompt action.

Misconceptions

When navigating the complex terrain of mental health legal procedures in Michigan, particularly related to involuntary hospitalization, the PCM 209 form plays a crucial role. However, misconceptions about this form abound, causing confusion and anxiety. By addressing these misunderstandings, clarity can be brought to an otherwise daunting process.

Misconception #1: The PCM 209 form can be used for immediate hospitalization without any prior steps.

This is not accurate. The PCM 209 form is actually a supplementary petition, which means it comes into play after an initial application for hospitalization (PCM 201) has been made and an effort to have the individual voluntarily examined by a health professional has failed. It's a subsequent step in the process, not the first one.

Misconception #2: Any individual can be compelled to undergo an examination once the PCM 209 is filed.

In truth, the court first evaluates the necessity and reasonableness of the examination request. Not every petition results in an order for compulsory examination. The court takes several factors into consideration, ensuring that the rights of the individual are balanced against the need for an evaluation.

Misconception #3: Completing the PCM 209 form guarantees police intervention.

While the form does include provisions for a peace officer to take the individual into protective custody for transport to a preadmission screening unit, this outcome is contingent upon the court's findings. The court's decision to order such measures depends on whether it's deemed necessary for the individual's well-being and public safety.

Misconception #4: The petitioner needs no evidence of their efforts to have the individual examined.

Contrary to this belief, the petitioner must detail their attempts to secure a voluntary examination by a physician or licensed psychologist. This demonstrates to the court that reasonable efforts were made to avoid compulsory intervention, adhering to the principle of least restrictive measures.

Misconception #5: Any refusal of examination leads directly to hospitalization.

This is a misunderstanding. Even if the court orders an examination, the subsequent steps depend on the outcome of that examination. Hospitalization may be one potential outcome, but it is based on the professional assessment of the individual’s mental health status and the degree of risk they may pose to themselves or others, not simply on the refusal to undergo an examination.

Key takeaways

Understanding the PCM 209 Michigan form, officially known as the Supplemental Petition to Application for Hospitalization and Order for Examination, is crucial for those navigating the mental health legal framework in Michigan. Here’s a breakdown of key takeaways to help guide individuals through the process.

  • Documentation of Efforts: The form requires the petitioner to document efforts made to have the individual examined by a physician or licensed psychologist. This documentation is essential to demonstrate to the court that all reasonable attempts have been made to obtain an examination voluntarily before seeking court intervention.
  • Role of Court: The court has a significant role in reviewing the application to ensure it is reasonable and in full compliance with section 424 of the Michigan Mental Health Code. The court's findings will determine whether or not it is necessary to order the individual to be taken into protective custody for an examination.
  • Peace Officer Involvement: One critical aspect of the PCM 209 form is the potential involvement of a peace officer to take the individual into protective custody and transport them to the preadmission screening unit. This step is considered only after the court finds it necessary based on the application and efforts documented by the petitioner.
  • Time-sensitive Process: The order for examination, if granted, requires that the individual be presented for examination within 10 days of the date of execution of the application. This highlights the process's urgency and the importance of timely action by all parties involved.

Filling out and understanding the PCM 209 form is a critical step in seeking court-ordered mental health examinations in Michigan. It serves as a procedural safeguard, ensuring that individuals are given proper consideration and that all other avenues have been explored before resorting to court-ordered examinations. The form outlines the process, requirements, and legal standards, playing a vital role in the intersection of mental health care and the legal system.

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