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Statement Of Emergency Detention By Law Enforcement Officer ME-901 - Wisconsin
| Statement Of Emergency Detention By Law Enforcement Officer Form. This is a Wisconsin form and can be used in Medical Circuit Court Statewide . |
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STATE OF WISCONSIN, CIRCUIT COURT, IN THE MATTER OF THE CONDITION OF COUNTY For Official Use Name of Subject Statement of Emergency Detention by Law Enforcement Officer Law Enforcement Agency No. Court Case No. Date of Birth · File this statement with the detention facility and court immediately. A probable cause hearing must be held within 72 hours of detention. (In Milwaukee County, file this statement with detention facility only.) · Please print or type all information below. All blanks must be filled in. I am a law enforcement officer and have cause to believe: · The subject is mentally ill, drug dependent, or developmentally disabled. · The subject evidences behavior which constitutes a substantial probability of physical harm to self or to others, or as otherwise set forth in §51.15(1), Wisconsin Statutes. My belief is based on specific and recent dangerous acts, attempts, threats or omissions by the subject as observed by me or reliably reported to me as stated below: Dangerous Behavior: When: Where: Describe Behavior: See attached page Witnesses to the dangerous behavior: (including officers who observed behavior) Name of Witness Telephone Mailing Address Relationship (Name) of the Board) approves the need for this detention. The subject was detained at (Name of §51.15(2) Facility) on (Date) , at (Time) Subject's Street Address City County department of community programs (§51.42(3) , am. County pm. State Zipcode Signature of Officer Department DISTRIBUTION: 1. Court Original 2. §51.15(2) Detention Facility 3. Subject with Notice of Rights Name Printed or Typed Telephone ME-901, 02/11 Statement of Emergency Detention by Law Enforcement Officer §51.15(4) and (5), Wisconsin Statutes American LegalNet, Inc. www.FormsWorkFlow.com This form shall not be modified. It may be supplemented with additional material.
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