Order Following Notice Of Noncompliance Wtih Assisted Outpatient Treatment {PCM 244}

Approved, SCAO PCS CODE: OFN TCS CODE: OFN STATE OF MICHIGAN PROBATE COURT COUNTY OF In the matter of ORDER AFTER NOTICE OF NONCOMPLIANCE FILE NO. WITH ASSISTED OUTPATIENT TREATMENT OR COMBINED HOSPITALIZATION AND ASSISTED OUTPATIENT TREATMENT ORDER First, middle, and last name 1. Date of hearing (if one): 2. This court issued an order on Date Judge: Bar no. directing the individual named above to undergo a program of assisted outpatient treatment or combined hospitalization and assisted outpatient treatment. 3.Thecourthasbeennotifiedthattheindividualisnotcomplyingwiththeorderforassistedoutpatienttreatmentorcombined hospitalization and assisted outpatient treatment. 4. THE COURT FINDS: IT IS ORDERED: 5.Apeaceofficershalltaketheindividualintoprotectivecustodyandtransporttheindividualto thepreadmissionscreeningunitestablishedbythecommunitymentalhealthservicesprogramservingthecommunity inwhichtheindividualresides. Designatedfacility 6. The individual shall be hospitalized at foraperiodofnotmorethan10days.Ifnecessary,apeaceofficershalltaketheindividualintoprotectivecustody. asrecommendedbythecommunitymentalhealthservicesprogram,morethan10daysbutnotlongerthantheduration of the order for assisted outpatient treatment or a combination of hospitalization and assisted outpatient treatment, or notlongerthan90days,whicheverisless.Ifnecessary,apeaceofficershalltaketheindividualintoprotectivecustody. 7.Theindividualmayreturntoassistedoutpatienttreatmentbeforetheexpirationofthepriororderofassistedoutpatient treatmentorcombinedhospitalizationandassistedoutpatienttreatmentasfollows: Date Judge NOTICE OF RIGHT TO OBJECT TO HOSPITALIZATION Ifthecourtordered,withoutahearing,thatyoubehospitalized,youhavearighttoobjecttothishospitalization.Ifyouwishto object,completetheobjectionbelowandsendacopytothecourtwithin7daysofreceivingthisnotice. PROOF OF SERVICE Icertifythatthisnoticewaspersonallyservedontheaboveindividualon andacopymailedtothe Signature Date at Court on Date Time . OBJECTION TO HOSPITALIZATION IobjecttomyhospitalizationandrequestthatthecourtscheduleahearingontheobjectioninaccordancewithMCR5.744. Date Signature Do not write below this line - For court use only PCM 244 (9/16) ORDER AFTER NOTICE OF NONCOMPLIANCE WITH ASSISTED OUTPATIENT TREATMENT OR COMBINED HOSPITALIZATION AND ASSISTED OUTPATIENT TREATMENT ORDER American LegalNet, Inc. MCL 330.1475(3), (4), (5), (6), MCR 5.744 www.FormsWorkFlow.com