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Petition For Discharge From Continuing Treatment PCM 220 - Michigan
| Petition For Discharge From Continuing Treatment Form. This is a Michigan form and can be used in Mental Health Statewide . |
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Approved, SCAO JIS CODE: DIP STATE OF MICHIGAN PROBATE COURT COUNTY CIRCUIT COURT - FAMILY DIVISION FILE NO. PETITION FOR DISCHARGE FROM CONTINUING TREATMENT In the matter of 1. I, Name (type or print) , state that the individual is subject to a one-year order of involuntary mental health treatment and I am the executive director of the community mental health services program for the county of residence of the individual. hospitalized in Name of hospital . under a one-year alternative or a one-year combined treatment order under the supervision of . 2. I object to the conclusion(s) in the periodic review report of Name of patient/resident dated and filed with this court. The individual named in that report is not a person requiring continuing involuntary mental health treatment and should be discharged from the program. 3. The interested parties, their addresses, and their representatives are identical to those appearing on the initial petition, except as follows: 4. I REQUEST that the court set a hearing and order a discharge. I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief. Date Signature of petitioner Do not write below this line - For court use only PCM 220 (9/09) PETITION FOR DISCHARGE FROM CONTINUING TREATMENT American LegalNet, Inc. www.FormsWorkFlow.com MCL 330.1484
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