Missouri > Local Circuit Courts > 7th Circuit (Clay County) > Probate > Adults
Order To Transport (Mentally Disordered Person) 378-A - Missouri
| Order To Transport (Mentally Disordered Person) Form. This is a Missouri form and can be used in Adults Probate 7th Circuit (Clay County) Local Circuit Courts . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
CIRCUIT COURT OF CLAY COUNTY, MISSOURI PROBATE DIVISION No. Matter of , an incapacitated person. ORDER TO TRANSPORT On this _____ day of ___________________________________, 20____, the Court considers the application of the Guardian herein requesting the transportation of , to a mental health facility. The Court finds that there is reasonable cause to believe that the Ward is mentally disordered, and presents a likelihood of serious physical harm to *her___ / *him___self or to others and should be transported to a mental health facility by the sheriff. WHEREFORE, IT IS HEREBY ORDERED THAT the Sheriff of Clay County, Missouri, take said into custody and transport *her___/*him___ to , an appropriate mental health facility, where the Guardian will make application for *her___ / *his___ admission. JUDGE Executed this order on , 20_______. Sheriffs Fees $_______.____ Sheriff____________________________________ Mileage $_______.____ Total $_______.____ BY:____________________________________ Deputy Sheriff, Clay County, Missouri *Strike if inapplicable Form 378-A Page 1 of 1 Revised 3/14/2003
|
|||||||
