Application For Involuntary Emergency Examination And Teatment {MH 783}

MH 783 - APPLICATION FOR INVOLUNTARY EMERGENCY EXAMINATION AND TREATMENT. This form is used under Section 302 of the Pennsylvania Mental Health Procedures Act of 1976 to initiate an emergency psychiatric evaluation for an individual who is believed to be a danger to themselves or others due to symptoms of mental illness. The form allows a concerned party—such as a family member, medical professional, law enforcement officer, or county delegate—to request a legal warrant or authorize emergency transport for a person in mental health crisis. It includes detailed attestations, behavioral descriptions, and legal standards that justify the need for immediate, involuntary evaluation. Once completed, the form is reviewed by the County Mental Health Administrator or delegate, who may issue a warrant for the individual’s emergency transport to a mental health facility. It also documents whether the individual was advised of their rights, the steps taken to secure their personal property and care for dependents, and the outcome of their psychiatric examination by a physician. The form ensures that proper legal procedures are followed while prioritizing the individual’s safety and due process. If the physician determines the person meets the statutory criteria for involuntary treatment, the person may be detained and treated for up to 120 hours under the 302 provision. www.FormsWorkflow.com