Statement Of Noncompliance With Order Of Involuntary Administration of Medication {GN-4210}

GN-4210 - STATEMENT OF NONCOMPLIANCE WITH ORDER FOR INVOLUNTARY ADMINISTRATION OF PSYCHOTROPIC MEDICATION. This is a Wisconsin Circuit Court form used when a ward subject to an existing §55.14 order refuses to take prescribed psychotropic medication. The form requires the petitioner—typically corporation counsel, the guardian, or a county department representative—to describe the original court order, the ward’s noncompliance, and the factual basis for determining that forcible transport and restraint are necessary. It also requests court authorization allowing law enforcement to take the ward into custody and transport them to an appropriate facility for medication administration. Each signer must affirm the accuracy of the submission under penalty of false swearing. §55.14(9), Wisconsin Statutes. www.FormsWorkflow.com