California > Judicial Council > Juvenile
Order Regarding Application For Psychotropic Medication JV-223 - California
| Order Regarding Application For Psychotropic Medication Form. This is a California form and can be used in Juvenile Judicial Council . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
JV-223 Order Regarding Application for Psychotropic Medication Clerk stamps date here when form is filed. The Court read and considered: a. JV-220, Application Regarding Psychotropic Medication, and JV-220(A), Prescribing Physician's Statement--Attachment, filed on (date): b. c. JV-222, Opposition to Application Regarding Psychotropic Medication, filed on (date): Other (specify): Fill in court name and street address: The Court finds and orders: 1 a. b. Notice requirements were met. Notice requirements were not met. Proper notice was not given to: Superior Court of California, County of Fill in child's name and date of birth: 2 The matter is set for hearing on (date): at (time): in (dept.): Child's Name: Date of Birth: Fill in case number when form is filed. 3 Application was made for authorization to begin or to continue giving the child the psychotropic medication listed in 15 on page 3 of JV-220(A). A copy of page 3 is attached to this order. The application is (check one): a. granted as requested. b. . Case Number: granted with the following modification or conditions to the request as made in page 3 of JV-220(A) (specify all modifications and conditions): 15 on the attached c. denied (specify reason for denial): 4 Other (specify): This order is effective until terminated or modified by court order or until 180 days from the date of this order, whichever is earlier. If the prescribing physician is no longer treating the child, this order extends to subsequent treating physicians. A change in the child's placement does not require a new order regarding psychotropic medication. Except in an emergency situation, a new application must be submitted and consent granted by the court before giving the child medication not authorized in this order or increasing medication dosage beyond the maximum daily dosage authorized in this order. Date: Signature of judge or judicial officer Judicial Council of California, www.courtinfo.ca.gov New January 1, 2008, Mandatory Form Welfare and Institution Code, ยง 369.5 California Rules of Court, rule 5.640 Order Regarding Application for Psychotropic Medication JV-223, Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com
|
|||||||
