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Order For Counseling And Testing For Disease Infection MC 234 - Michigan
| Order For Counseling And Testing For Disease Infection Form. This is a Michigan form and can be used in General Criminal Statewide . |
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Original - Court 2nd copy - Defendant/Juvenile Approved, SCAO 1st copy - Prosecuting attorney or victim advocate 3rd copy - Testing agency/Physician STATE OF MICHIGAN CASE NO. JUDICIAL DISTRICT ORDER FOR COUNSELING AND TESTING JUDICIAL CIRCUIT FOR DISEASE/INFECTION Court address Court telephone no. The State of Michigan Defendants/Juveniles name, address, and telephone no. THE PEOPLE OF v Juvenile In the matter of defendant/juvenile was arraigned on a warrant for: defendant was assigned to youthful trainee status for: defendant/juvenile was convicted of: defendant/juvenile was bound over to the circuit court for: 1. On juvenile was found to be within the provisions of MCL 712A.2 for violation of: Date Specify (see reverse side for list of violations) on bond 2. The defendant/juvenile is incarcerated in .IT IS ORDERED: 3. The defendant/juvenile shall receive counseling regarding venereal disease, hepatitis B infection, human immunodeficiency virus (HIV) infection; acquired immunodeficiency syndrome; and acquired immunodeficiency syndrome related complex including, at a minimum, information regarding treatment, transmission, and protective measures from: a local health department, an assigned counseling and testing agency, a licensed physician, at the defendants/juveniles expense, Name of physician or contact person of agency or health department and address .4. The defendant/juvenile shall be confidentially tested for venereal disease, hepatitis B infection, and for the presence of HIV or an antibody to HIV from the agency or person providing the counseling. The person or agency administering the test shall transmit the test results and any other medical information obtained from the defendant/juvenile to this court. The test results will be made part of the court record but are confidential and shall be disclosed only to those specified in statute. 5. If authorized by the victim or victims representative, the victim advocate of the prosecuting office shall immediately forward the name, address, and telephone number of the victim or the victims representative to the physician or agency administering the test on the defendant/juvenile. 6. All testing and counseling of the defendant/juvenile must be completed and test results transmitted to the court: before the sentencing/dispositional hearing date on . within 30 days of this order. Test results must be transmitted to: the circuit court at . this court at the address stated above. Failure to comply may result in penalty for contempt of court. Date Judge/Magistrate Bar no.See other side for instructions and a list of persons subject to testing and counseling under MCL 333.5129. MC 234 (1/02) ORDER FOR COUNSELING AND TESTING FOR DISEASE/INFECTION MCL 333.5129, MCL 333.5131<<<<<<<<<********>>>>>>>>>>>>> 2 INSTRUCTIONS1. Even if the defendant is convicted of a lesser offense, this form is to be used under: MCL 333.5129 to order testing and counseling when a defendant is arraigned on a warrant in the district court or bound over to circuit court for specific sex offenses as listed below when the district court determines there is reason to believe the violation involved sexual penetration or exposure to a body fluid of the defendant. defendant is convicted of, or assigned to youthful trainee status for, specific sex offenses as listed below; or juvenile is found to come under the provisions of MCL 712A.2 for violation of specific sex offenses as listed below.2. Item 5. applies only if the victim has consented to release of name, address, and phone number on Department of Public Health form AP 109. PERSONS SUBJECT TO TESTING AND COUNSELING UNDER MCL 333.5129Persons charged with violations and convicted of/found responsible for same or lesser offense of: (*testing not required if the courtdetermines there is no reason to believe the violation involved sexual penetration or exposure to a body fluid of defendant) *MCL 333.7404 Use of controlled dangerous substance; penalties (specifically, intravenous use)MCL 750.145a Accosting, enticing, or soliciting child for immoral purposesMCL 750.338 Gross indecency; between male personsMCL 750.338a Gross indecency; between female personsMCL 750.338b Gross indecency; between male and female persons *MCL 750.448 Soliciting and accosting *MCL 750.449 Admitting to place for purpose of prostitutionMCL 750.449a Engaging services for purpose of prostitution, lewdness, or assignation, offer to engage; penaltyMCL 750.450 Aiders and abettors MCL 750.452 House of ill fame, keeping, maintaining or operatingMCL 750.455 Pandering MCL 750.520b First degree criminal sexual conductMCL 750.520c Second degree criminal sexual conductMCL 750.520d Third degree criminal sexual conductMCL 750.520e Fourth degree criminal sexual conductMCL 750.520g Assault with intent to commit criminal sexual conduct
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