State Codes and Statutes

Statutes > California > Wic > 6250-6254

WELFARE AND INSTITUTIONS CODE
SECTION 6250-6254



6250.  As used in this part, "persons subject to judicial commitment"
means persons who may be judicially committed under this part as
mentally disordered sex offenders pursuant to Article 1 (commencing
with Section 6300), sexually violent predators pursuant to Article 4
(commencing with Section 6600), or mentally retarded persons pursuant
to Article 2 (commencing with Section 6500) of Chapter 2 of this
part.
   Nothing in this part shall be held to change or interfere with the
provisions of the Penal Code and other laws relating to mentally
disordered persons charged with crime or to the criminally insane.
   This part shall be liberally construed so that, as far as possible
and consistent with the rights of persons subject to commitment,
those persons shall be treated, not as criminals, but as sick
persons.



6251.  Wherever, on the basis of a petition, provision is made in
this code for issuing and delivering an order for examination and
detention directing that a person be apprehended and taken before a
judge of a superior court for a hearing and examination on an
allegation of being a person subject to judicial commitment, the
petition shall be in substantially the following form:

         In the Superior Court of the State of
                       California
                 For the County of ____
  The People
                                            )
  For the Best Interest and Protection      )
  of                                        )
  _________________________________________
  as a ____________________________________ )
  and                                       ) Petitio
  Concerning                                )    n
  ___________________ and
  _________________________________________ )
                                            )
  Respondents                               )
  _________________________________________
  __________
  _______, residing at ______ (tel. _______), being
  duly sworn deposes and
  says:  That there is now in the county in the City
  or Town of __________
  a person named ______, who resides at ______, and
  who is believed to be
  a ______.  That the person is ____ years of age;
  that __ the person is ____  (sex) and that __ the
  person is ____ (single, married, widowed, or
  divorced); and that ____ occupation is ____.
  That the facts because of which petitioner
  believes that the person is a  ____ are as
  follows:  That __ the person, at _______ in the
  county, on
  the____ day of ____,  20__,
  ___________________________________________________
  That petitioner's interest in and case is
  ___________________________________________________
  ___________________________________________________
  That petitioner believes that said person is ____
  as  defined in Section  ____.
  That the persons responsible for the care,
  support, and maintenance of the  ____, and their
  relationship to  the person are, so far as known
  to the  petitioner, as
  follows:
  (Give names, addresses, and relationship of
  persons named as respondents)
  Wherefore, petitioner prays that examination be
  made to determine the
  state of the mental health of ____, alleged to be
  ____, and that such measures
  be taken for the best interest and protection of
  said ____, in respect to
  the person's supervision, care and treatment, as
  may be necessary and provided by law.
               ______________________________________
                                           Petitioner
  Subscribed and sworn to before me this ____ day of
  ______, 20__.
  ________________________________, Clerk of the
  Court
  By _____________________________________________
  Deputy



6252.  Wherever provision is made in this code for a judge of a
superior court to issue and deliver an order for examination or
detention directing that a person be apprehended and taken before a
judge of a superior court for a hearing and examination on an
allegation of being a person subject to judicial commitment, the
order for examination or detention shall be in substantially the
following form:
__________________________________________
The People )
For the Best Interest and Protection of )
_______________________________________ ) Order
as a __________________________________ ) for
and Concerning ) Examination
___________________________________ and ) or
_______________________________________ ) Detention
Respondents )
__________________________________________)

The People of the State of California __________
___________________________________________________
(peace officer)

The petition for ____ having been presented this
day to me, a Judge of the Superior Court in and for
the County of ____, State of California, from which
it appears that there is now in this county, at ____,
a person by the name of ____, who is a ____.
And it satisfactorily appears to me that said per-
son is sufficiently ____ that examination should be
made and hearing held, if demanded, to determine the
supervision, treatment, care or restraint, if any,
necessary for his best interest and protection, and
the protection of the people.
I do hereby appoint ____ and ____ as medical
examiners to make a personal examination of ____,
the person alleged to be ____, and to report thereon
to the court, pursuant to Section ____ of the Welfare
and Institutions Code.
*Now, therefore, you are commanded to notify said
____, to submit to an examination ____ on or before
the ____ day of ____, that thereafter he may be taken
before a judge of the superior court in this county
for examination and hearing to determine the measures
to be taken for the best interest and protection of
said ____, as a ____, as provided by law.
*And it affirmatively appearing to me that said
person is sufficiently ____ that he is likely to
injure himself or others if not immediately hos-
pitalized or detained, you are therefore commanded
to forthwith detain said ____, or cause him to be
detained for examination and hearing, pending the
further order of the judge, at ____, and there be
cared for in a humane manner as a ____ and provided
with any medical treatment deemed necessary to his
physical well-being.
*And it satisfactorily appearing to me that said
person has failed or has refused to appear for exami-
nation when notified by order of this court, you are
therefore commanded to forthwith detain said ____ or
cause him to be detained for examination and hearing,
pending the further order of the judge, at ____, and
there be cared for in a humane manner as a ____.
I hereby direct that a copy of this order,
together with a copy of the said petition be
delivered to said person and his representative,
if any, at the time of his notification; and I
further direct that this order may be served at
any hour of the night.
Witness my hand, this ____ day of ____, 19__.
_____________________________________
Judge of the Superior Court

*Strike out when not applicable.

Return of Order

I hereby certify that I received the above order
for examination or detention, and on the ____ day
of ____, 19__, served it by notifying and delivering
to said ____ personally, and to his representatives,
if any, to wit, ____, a copy of the order and of the
petition, *or by apprehending said person and causing
h__ to be detained for examination and hearing and for
humane care as an alleged ____ at ____; until further
ordered and directed by the judge.
*I hereby certify that prior to the service of the
above order for detention and the apprehension of ___
I served notice on the person and his representative,
if any, as required under Article 2 (commencing with
Section 5200) of Chapter 2 of Part 1 of Division 5 of
the Welfare and Institutions Code.

Dated __________, 19__.
______________________________________
Signature of officer

*Strike out when not applicable.



6253.  Wherever provision is made in this code for court-appointed
medical examiners to make and sign a certificate showing the facts of
an examination in the case of a person alleged to be subject to
judicial commitment, the certificate shall be in substantially the
following form:
In the Superior Court of the State of California
for the County of ________

___________________________________________________
The People )
For the Best Interest and )
Protection of _______________________________, )
as a _________________________________________ ) Certificate
and Concerning ) of Medical
_______________________________________________, ) Examiners
and ___________________________________________, )
Respondents )
___________________________________________________)

We, Dr. ____ and Dr. ____, medical examiners in the County of
____, duly appointed and certified as such, do hereby certify under
our hands that we have examined ____, alleged to be a ____, and have
attended before a judge of said court at the hearing on the petition
concerning said person, and have heard the testimony of all
witnesses,
and, as a result of the examination, have testified under oath
before
the court to the following facts concerning the alleged
____________:
Name
________________________________________________________________
Address _____________________________________________________________
Age _________________________________ Sex
___________________________
Occupation ________ Marital status _________________________________
(Single, married, widowed, divorced)
Religious belief
____________________________________________________
Pertinent case history
______________________________________________

_____________________________________________________________________

_____________________________________________________________________
General physical condition
__________________________________________

_____________________________________________________________________
Present mental status
_______________________________________________

_____________________________________________________________________

_____________________________________________________________________
Laboratory reports (if any)
_________________________________________

_____________________________________________________________________
Tentative diagnosis of mental health
________________________________
_____________________________________________________________________

_____________________________________________________________________
Recommendation for disposition or supervision, treatment and care
___

_____________________________________________________________________

_____________________________________________________________________
Reasons for the recommendation
______________________________________

_____________________________________________________________________

_____________________________________________________________________
_____________________________________________________________________

Date ___________________
_________________________________________
Medical Examiner
_________________________________________
Medical Examiner




6254.  Wherever provision is made in this code for an order of
commitment by a superior court, the order of commitment shall be in
substantially the following form:
In the Superior Court of the State of California
for the County of ____

______________________________________
The People )
For the Best Interest and )
Protection of _____________________ )
as a _____________________________, ) Order for Care,
) Hospitalization
and Concerning ) or Commitment
_______________________________ and )
______________________, Respondents )
______________________________________)

The petition dated ____, alleging that ____, having been
presented to this court on the ____ day of ____, 19_, and
an order of detention issued thereon by a judge of the
superior court of this county, and a return of the said
order:
And it further appearing that the provisions of Sections
6250 to 6254, inclusive, of the Welfare and Institutions
Code have been complied with;
And it further appearing that Dr. ____ and Dr. ____, two
regularly appointed and qualified medical examiners of this
county, have made a personal examination of the alleged ____,
and have made and signed the certificate of the medical
examiners, which certificate is attached hereto and made
a part hereof;
Now therefore, after examination and certificate made
as aforesaid the court is satisfied and believes that
____ is a ____ and is so ____.
It is ordered, adjudged and decreed:
That ____ is a ____ and that _he
* (a) Be cared for and detained in ____, a county
psychiatric hospital, a community mental health service,
or a licensed sanitarium or hospital for the care of the
mentally disordered until the further order of the court, or
* (b) Be cared for at ____, until the further order of the
court, or
* (c) Be committed to the State Department of Mental Health
for placement in a state hospital, or
* (d) Be committed to a facility of the Veterans Administration
or other agency of the United States, to wit: _____ at ____.
It is further ordered and directed that ____ of this
county, take, convey and deliver ____ to the proper
authorities of the hospital or establishment designated
herein to be cared for as provided by law.

Dated this ____ day of ____, 19_.
_______________________________________
Judge of the Superior Court

* Strike out where inapplicable.


State Codes and Statutes

Statutes > California > Wic > 6250-6254

WELFARE AND INSTITUTIONS CODE
SECTION 6250-6254



6250.  As used in this part, "persons subject to judicial commitment"
means persons who may be judicially committed under this part as
mentally disordered sex offenders pursuant to Article 1 (commencing
with Section 6300), sexually violent predators pursuant to Article 4
(commencing with Section 6600), or mentally retarded persons pursuant
to Article 2 (commencing with Section 6500) of Chapter 2 of this
part.
   Nothing in this part shall be held to change or interfere with the
provisions of the Penal Code and other laws relating to mentally
disordered persons charged with crime or to the criminally insane.
   This part shall be liberally construed so that, as far as possible
and consistent with the rights of persons subject to commitment,
those persons shall be treated, not as criminals, but as sick
persons.



6251.  Wherever, on the basis of a petition, provision is made in
this code for issuing and delivering an order for examination and
detention directing that a person be apprehended and taken before a
judge of a superior court for a hearing and examination on an
allegation of being a person subject to judicial commitment, the
petition shall be in substantially the following form:

         In the Superior Court of the State of
                       California
                 For the County of ____
  The People
                                            )
  For the Best Interest and Protection      )
  of                                        )
  _________________________________________
  as a ____________________________________ )
  and                                       ) Petitio
  Concerning                                )    n
  ___________________ and
  _________________________________________ )
                                            )
  Respondents                               )
  _________________________________________
  __________
  _______, residing at ______ (tel. _______), being
  duly sworn deposes and
  says:  That there is now in the county in the City
  or Town of __________
  a person named ______, who resides at ______, and
  who is believed to be
  a ______.  That the person is ____ years of age;
  that __ the person is ____  (sex) and that __ the
  person is ____ (single, married, widowed, or
  divorced); and that ____ occupation is ____.
  That the facts because of which petitioner
  believes that the person is a  ____ are as
  follows:  That __ the person, at _______ in the
  county, on
  the____ day of ____,  20__,
  ___________________________________________________
  That petitioner's interest in and case is
  ___________________________________________________
  ___________________________________________________
  That petitioner believes that said person is ____
  as  defined in Section  ____.
  That the persons responsible for the care,
  support, and maintenance of the  ____, and their
  relationship to  the person are, so far as known
  to the  petitioner, as
  follows:
  (Give names, addresses, and relationship of
  persons named as respondents)
  Wherefore, petitioner prays that examination be
  made to determine the
  state of the mental health of ____, alleged to be
  ____, and that such measures
  be taken for the best interest and protection of
  said ____, in respect to
  the person's supervision, care and treatment, as
  may be necessary and provided by law.
               ______________________________________
                                           Petitioner
  Subscribed and sworn to before me this ____ day of
  ______, 20__.
  ________________________________, Clerk of the
  Court
  By _____________________________________________
  Deputy



6252.  Wherever provision is made in this code for a judge of a
superior court to issue and deliver an order for examination or
detention directing that a person be apprehended and taken before a
judge of a superior court for a hearing and examination on an
allegation of being a person subject to judicial commitment, the
order for examination or detention shall be in substantially the
following form:
__________________________________________
The People )
For the Best Interest and Protection of )
_______________________________________ ) Order
as a __________________________________ ) for
and Concerning ) Examination
___________________________________ and ) or
_______________________________________ ) Detention
Respondents )
__________________________________________)

The People of the State of California __________
___________________________________________________
(peace officer)

The petition for ____ having been presented this
day to me, a Judge of the Superior Court in and for
the County of ____, State of California, from which
it appears that there is now in this county, at ____,
a person by the name of ____, who is a ____.
And it satisfactorily appears to me that said per-
son is sufficiently ____ that examination should be
made and hearing held, if demanded, to determine the
supervision, treatment, care or restraint, if any,
necessary for his best interest and protection, and
the protection of the people.
I do hereby appoint ____ and ____ as medical
examiners to make a personal examination of ____,
the person alleged to be ____, and to report thereon
to the court, pursuant to Section ____ of the Welfare
and Institutions Code.
*Now, therefore, you are commanded to notify said
____, to submit to an examination ____ on or before
the ____ day of ____, that thereafter he may be taken
before a judge of the superior court in this county
for examination and hearing to determine the measures
to be taken for the best interest and protection of
said ____, as a ____, as provided by law.
*And it affirmatively appearing to me that said
person is sufficiently ____ that he is likely to
injure himself or others if not immediately hos-
pitalized or detained, you are therefore commanded
to forthwith detain said ____, or cause him to be
detained for examination and hearing, pending the
further order of the judge, at ____, and there be
cared for in a humane manner as a ____ and provided
with any medical treatment deemed necessary to his
physical well-being.
*And it satisfactorily appearing to me that said
person has failed or has refused to appear for exami-
nation when notified by order of this court, you are
therefore commanded to forthwith detain said ____ or
cause him to be detained for examination and hearing,
pending the further order of the judge, at ____, and
there be cared for in a humane manner as a ____.
I hereby direct that a copy of this order,
together with a copy of the said petition be
delivered to said person and his representative,
if any, at the time of his notification; and I
further direct that this order may be served at
any hour of the night.
Witness my hand, this ____ day of ____, 19__.
_____________________________________
Judge of the Superior Court

*Strike out when not applicable.

Return of Order

I hereby certify that I received the above order
for examination or detention, and on the ____ day
of ____, 19__, served it by notifying and delivering
to said ____ personally, and to his representatives,
if any, to wit, ____, a copy of the order and of the
petition, *or by apprehending said person and causing
h__ to be detained for examination and hearing and for
humane care as an alleged ____ at ____; until further
ordered and directed by the judge.
*I hereby certify that prior to the service of the
above order for detention and the apprehension of ___
I served notice on the person and his representative,
if any, as required under Article 2 (commencing with
Section 5200) of Chapter 2 of Part 1 of Division 5 of
the Welfare and Institutions Code.

Dated __________, 19__.
______________________________________
Signature of officer

*Strike out when not applicable.



6253.  Wherever provision is made in this code for court-appointed
medical examiners to make and sign a certificate showing the facts of
an examination in the case of a person alleged to be subject to
judicial commitment, the certificate shall be in substantially the
following form:
In the Superior Court of the State of California
for the County of ________

___________________________________________________
The People )
For the Best Interest and )
Protection of _______________________________, )
as a _________________________________________ ) Certificate
and Concerning ) of Medical
_______________________________________________, ) Examiners
and ___________________________________________, )
Respondents )
___________________________________________________)

We, Dr. ____ and Dr. ____, medical examiners in the County of
____, duly appointed and certified as such, do hereby certify under
our hands that we have examined ____, alleged to be a ____, and have
attended before a judge of said court at the hearing on the petition
concerning said person, and have heard the testimony of all
witnesses,
and, as a result of the examination, have testified under oath
before
the court to the following facts concerning the alleged
____________:
Name
________________________________________________________________
Address _____________________________________________________________
Age _________________________________ Sex
___________________________
Occupation ________ Marital status _________________________________
(Single, married, widowed, divorced)
Religious belief
____________________________________________________
Pertinent case history
______________________________________________

_____________________________________________________________________

_____________________________________________________________________
General physical condition
__________________________________________

_____________________________________________________________________
Present mental status
_______________________________________________

_____________________________________________________________________

_____________________________________________________________________
Laboratory reports (if any)
_________________________________________

_____________________________________________________________________
Tentative diagnosis of mental health
________________________________
_____________________________________________________________________

_____________________________________________________________________
Recommendation for disposition or supervision, treatment and care
___

_____________________________________________________________________

_____________________________________________________________________
Reasons for the recommendation
______________________________________

_____________________________________________________________________

_____________________________________________________________________
_____________________________________________________________________

Date ___________________
_________________________________________
Medical Examiner
_________________________________________
Medical Examiner




6254.  Wherever provision is made in this code for an order of
commitment by a superior court, the order of commitment shall be in
substantially the following form:
In the Superior Court of the State of California
for the County of ____

______________________________________
The People )
For the Best Interest and )
Protection of _____________________ )
as a _____________________________, ) Order for Care,
) Hospitalization
and Concerning ) or Commitment
_______________________________ and )
______________________, Respondents )
______________________________________)

The petition dated ____, alleging that ____, having been
presented to this court on the ____ day of ____, 19_, and
an order of detention issued thereon by a judge of the
superior court of this county, and a return of the said
order:
And it further appearing that the provisions of Sections
6250 to 6254, inclusive, of the Welfare and Institutions
Code have been complied with;
And it further appearing that Dr. ____ and Dr. ____, two
regularly appointed and qualified medical examiners of this
county, have made a personal examination of the alleged ____,
and have made and signed the certificate of the medical
examiners, which certificate is attached hereto and made
a part hereof;
Now therefore, after examination and certificate made
as aforesaid the court is satisfied and believes that
____ is a ____ and is so ____.
It is ordered, adjudged and decreed:
That ____ is a ____ and that _he
* (a) Be cared for and detained in ____, a county
psychiatric hospital, a community mental health service,
or a licensed sanitarium or hospital for the care of the
mentally disordered until the further order of the court, or
* (b) Be cared for at ____, until the further order of the
court, or
* (c) Be committed to the State Department of Mental Health
for placement in a state hospital, or
* (d) Be committed to a facility of the Veterans Administration
or other agency of the United States, to wit: _____ at ____.
It is further ordered and directed that ____ of this
county, take, convey and deliver ____ to the proper
authorities of the hospital or establishment designated
herein to be cared for as provided by law.

Dated this ____ day of ____, 19_.
_______________________________________
Judge of the Superior Court

* Strike out where inapplicable.



State Codes and Statutes

State Codes and Statutes

Statutes > California > Wic > 6250-6254

WELFARE AND INSTITUTIONS CODE
SECTION 6250-6254



6250.  As used in this part, "persons subject to judicial commitment"
means persons who may be judicially committed under this part as
mentally disordered sex offenders pursuant to Article 1 (commencing
with Section 6300), sexually violent predators pursuant to Article 4
(commencing with Section 6600), or mentally retarded persons pursuant
to Article 2 (commencing with Section 6500) of Chapter 2 of this
part.
   Nothing in this part shall be held to change or interfere with the
provisions of the Penal Code and other laws relating to mentally
disordered persons charged with crime or to the criminally insane.
   This part shall be liberally construed so that, as far as possible
and consistent with the rights of persons subject to commitment,
those persons shall be treated, not as criminals, but as sick
persons.



6251.  Wherever, on the basis of a petition, provision is made in
this code for issuing and delivering an order for examination and
detention directing that a person be apprehended and taken before a
judge of a superior court for a hearing and examination on an
allegation of being a person subject to judicial commitment, the
petition shall be in substantially the following form:

         In the Superior Court of the State of
                       California
                 For the County of ____
  The People
                                            )
  For the Best Interest and Protection      )
  of                                        )
  _________________________________________
  as a ____________________________________ )
  and                                       ) Petitio
  Concerning                                )    n
  ___________________ and
  _________________________________________ )
                                            )
  Respondents                               )
  _________________________________________
  __________
  _______, residing at ______ (tel. _______), being
  duly sworn deposes and
  says:  That there is now in the county in the City
  or Town of __________
  a person named ______, who resides at ______, and
  who is believed to be
  a ______.  That the person is ____ years of age;
  that __ the person is ____  (sex) and that __ the
  person is ____ (single, married, widowed, or
  divorced); and that ____ occupation is ____.
  That the facts because of which petitioner
  believes that the person is a  ____ are as
  follows:  That __ the person, at _______ in the
  county, on
  the____ day of ____,  20__,
  ___________________________________________________
  That petitioner's interest in and case is
  ___________________________________________________
  ___________________________________________________
  That petitioner believes that said person is ____
  as  defined in Section  ____.
  That the persons responsible for the care,
  support, and maintenance of the  ____, and their
  relationship to  the person are, so far as known
  to the  petitioner, as
  follows:
  (Give names, addresses, and relationship of
  persons named as respondents)
  Wherefore, petitioner prays that examination be
  made to determine the
  state of the mental health of ____, alleged to be
  ____, and that such measures
  be taken for the best interest and protection of
  said ____, in respect to
  the person's supervision, care and treatment, as
  may be necessary and provided by law.
               ______________________________________
                                           Petitioner
  Subscribed and sworn to before me this ____ day of
  ______, 20__.
  ________________________________, Clerk of the
  Court
  By _____________________________________________
  Deputy



6252.  Wherever provision is made in this code for a judge of a
superior court to issue and deliver an order for examination or
detention directing that a person be apprehended and taken before a
judge of a superior court for a hearing and examination on an
allegation of being a person subject to judicial commitment, the
order for examination or detention shall be in substantially the
following form:
__________________________________________
The People )
For the Best Interest and Protection of )
_______________________________________ ) Order
as a __________________________________ ) for
and Concerning ) Examination
___________________________________ and ) or
_______________________________________ ) Detention
Respondents )
__________________________________________)

The People of the State of California __________
___________________________________________________
(peace officer)

The petition for ____ having been presented this
day to me, a Judge of the Superior Court in and for
the County of ____, State of California, from which
it appears that there is now in this county, at ____,
a person by the name of ____, who is a ____.
And it satisfactorily appears to me that said per-
son is sufficiently ____ that examination should be
made and hearing held, if demanded, to determine the
supervision, treatment, care or restraint, if any,
necessary for his best interest and protection, and
the protection of the people.
I do hereby appoint ____ and ____ as medical
examiners to make a personal examination of ____,
the person alleged to be ____, and to report thereon
to the court, pursuant to Section ____ of the Welfare
and Institutions Code.
*Now, therefore, you are commanded to notify said
____, to submit to an examination ____ on or before
the ____ day of ____, that thereafter he may be taken
before a judge of the superior court in this county
for examination and hearing to determine the measures
to be taken for the best interest and protection of
said ____, as a ____, as provided by law.
*And it affirmatively appearing to me that said
person is sufficiently ____ that he is likely to
injure himself or others if not immediately hos-
pitalized or detained, you are therefore commanded
to forthwith detain said ____, or cause him to be
detained for examination and hearing, pending the
further order of the judge, at ____, and there be
cared for in a humane manner as a ____ and provided
with any medical treatment deemed necessary to his
physical well-being.
*And it satisfactorily appearing to me that said
person has failed or has refused to appear for exami-
nation when notified by order of this court, you are
therefore commanded to forthwith detain said ____ or
cause him to be detained for examination and hearing,
pending the further order of the judge, at ____, and
there be cared for in a humane manner as a ____.
I hereby direct that a copy of this order,
together with a copy of the said petition be
delivered to said person and his representative,
if any, at the time of his notification; and I
further direct that this order may be served at
any hour of the night.
Witness my hand, this ____ day of ____, 19__.
_____________________________________
Judge of the Superior Court

*Strike out when not applicable.

Return of Order

I hereby certify that I received the above order
for examination or detention, and on the ____ day
of ____, 19__, served it by notifying and delivering
to said ____ personally, and to his representatives,
if any, to wit, ____, a copy of the order and of the
petition, *or by apprehending said person and causing
h__ to be detained for examination and hearing and for
humane care as an alleged ____ at ____; until further
ordered and directed by the judge.
*I hereby certify that prior to the service of the
above order for detention and the apprehension of ___
I served notice on the person and his representative,
if any, as required under Article 2 (commencing with
Section 5200) of Chapter 2 of Part 1 of Division 5 of
the Welfare and Institutions Code.

Dated __________, 19__.
______________________________________
Signature of officer

*Strike out when not applicable.



6253.  Wherever provision is made in this code for court-appointed
medical examiners to make and sign a certificate showing the facts of
an examination in the case of a person alleged to be subject to
judicial commitment, the certificate shall be in substantially the
following form:
In the Superior Court of the State of California
for the County of ________

___________________________________________________
The People )
For the Best Interest and )
Protection of _______________________________, )
as a _________________________________________ ) Certificate
and Concerning ) of Medical
_______________________________________________, ) Examiners
and ___________________________________________, )
Respondents )
___________________________________________________)

We, Dr. ____ and Dr. ____, medical examiners in the County of
____, duly appointed and certified as such, do hereby certify under
our hands that we have examined ____, alleged to be a ____, and have
attended before a judge of said court at the hearing on the petition
concerning said person, and have heard the testimony of all
witnesses,
and, as a result of the examination, have testified under oath
before
the court to the following facts concerning the alleged
____________:
Name
________________________________________________________________
Address _____________________________________________________________
Age _________________________________ Sex
___________________________
Occupation ________ Marital status _________________________________
(Single, married, widowed, divorced)
Religious belief
____________________________________________________
Pertinent case history
______________________________________________

_____________________________________________________________________

_____________________________________________________________________
General physical condition
__________________________________________

_____________________________________________________________________
Present mental status
_______________________________________________

_____________________________________________________________________

_____________________________________________________________________
Laboratory reports (if any)
_________________________________________

_____________________________________________________________________
Tentative diagnosis of mental health
________________________________
_____________________________________________________________________

_____________________________________________________________________
Recommendation for disposition or supervision, treatment and care
___

_____________________________________________________________________

_____________________________________________________________________
Reasons for the recommendation
______________________________________

_____________________________________________________________________

_____________________________________________________________________
_____________________________________________________________________

Date ___________________
_________________________________________
Medical Examiner
_________________________________________
Medical Examiner




6254.  Wherever provision is made in this code for an order of
commitment by a superior court, the order of commitment shall be in
substantially the following form:
In the Superior Court of the State of California
for the County of ____

______________________________________
The People )
For the Best Interest and )
Protection of _____________________ )
as a _____________________________, ) Order for Care,
) Hospitalization
and Concerning ) or Commitment
_______________________________ and )
______________________, Respondents )
______________________________________)

The petition dated ____, alleging that ____, having been
presented to this court on the ____ day of ____, 19_, and
an order of detention issued thereon by a judge of the
superior court of this county, and a return of the said
order:
And it further appearing that the provisions of Sections
6250 to 6254, inclusive, of the Welfare and Institutions
Code have been complied with;
And it further appearing that Dr. ____ and Dr. ____, two
regularly appointed and qualified medical examiners of this
county, have made a personal examination of the alleged ____,
and have made and signed the certificate of the medical
examiners, which certificate is attached hereto and made
a part hereof;
Now therefore, after examination and certificate made
as aforesaid the court is satisfied and believes that
____ is a ____ and is so ____.
It is ordered, adjudged and decreed:
That ____ is a ____ and that _he
* (a) Be cared for and detained in ____, a county
psychiatric hospital, a community mental health service,
or a licensed sanitarium or hospital for the care of the
mentally disordered until the further order of the court, or
* (b) Be cared for at ____, until the further order of the
court, or
* (c) Be committed to the State Department of Mental Health
for placement in a state hospital, or
* (d) Be committed to a facility of the Veterans Administration
or other agency of the United States, to wit: _____ at ____.
It is further ordered and directed that ____ of this
county, take, convey and deliver ____ to the proper
authorities of the hospital or establishment designated
herein to be cared for as provided by law.

Dated this ____ day of ____, 19_.
_______________________________________
Judge of the Superior Court

* Strike out where inapplicable.