Wisconsin > Statewide > Circuit Court > Juvenile
Petition For Examination Or Assessment JD-1731 - Wisconsin
| Petition For Examination Or Assessment Form. This is a Wisconsin form and can be used in Juvenile Circuit Court Statewide . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
FORM SUMMARY Name of Form: Form Number: Statutory Reference: Benchbook Reference: Purpose of Form: Petition For Examination or Assessment JD-1731 §§48.295 and 938.295, Wisconsin Statutes JV 6 To allow an interested person to request that the court order a physical, psychological, mental or developmental examination or AODA assessment. The party requesting the examination/assessment. Original is filed with the court, copies to child/juvenile/attorney/guardian ad litem, parent/guardian/legal custodian/attorney, petitioning attorney, agency, and other interested parties. Generally none, although the petitioner may attach additional documentation justifying the request when appropriate. Modification, last update 05/00. Changed signature line to read "Signature of Petitioner". Changed second check box in #5 to read "insurance company of child...". None This form is the product of the Wisconsin Records Management Committee, a committee of the Director of State Court's Office and a mandate of the Wisconsin Judicial Conference. If you have additional information that does not change the meaning of the form, attach it on a separate page. The form itself shall not be altered. Who Completes It: Distribution of Form: Accompanying Forms: New Form/Modification: Modifications: Comments: About this form: Date: 08/07/2007 Page 1 American LegalNet, Inc. www.FormsWorkflow.com For Official Use STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF Petition for Examination or Assessment Name Case No. Date of Birth I request that: 1. The court order a(n): mental examination physical examination alcohol or other drug assessment psychological examination other: developmental examination of the child/juvenile. parent(s): guardian: legal custodian: inpatient (chapter 938 only) and should be outpatient 2. This examination/assessment should be conducted by: a physician: a psychiatrist: a licensed psychologist: another expert (with a master's degree in social work or another related field of child development): an approved treatment facility for alcohol and other drug abuse: 3. This examination/assessment should evaluate the following: mental condition physical condition developmental condition mental competency to proceed ability of the parents to care for the child/juvenile psychological status alcohol or other drug abuse dependency whether the juvenile at the time of commission of the alleged delinquent act was not responsible by reason of mental disease or defect the appropriateness of medication, including psychotropic medications other: 4. This evaluation should be done because: 5. The expenses of this examination be paid by: the parents, guardian or legal custodian: insurance company of child/juvenile/parents/guardian/legal custodian: the county. the state. Signature of Petitioner Distribution: 1. Original - Court 2. Child/Juvenile/Attorney 3. Parents Name Printed or Typed Date JD-1731, 08/07 Petition for Examination or Assessment §§48.295, 938.295, Wisconsin Statutes. American LegalNet, Inc. www.FormsWorkflow.com This form shall not be modified. It may be supplemented with additional material. Page 1 of 1
|
|||||||
