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Get Mental Health Petition Form 2019-2024

D last name , state that I am Name (type or print) the authorized representative of the agency or mental health professional supervising the individual s assisted outpatient treatment program. of Director or authorized representative Name of hospital 2. The individual is currently residing hospitalized at . Address and telephone no. . 3. The initial order entered by this court for the individual expires on Date . 4. The individual contin.

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