Report On Examination And Clinical Certificate {PCM 208}

Form PCM 208 - REPORT ON EXAMINATION AND CLINICAL CERTIFICATE. This form is used in Michigan when a court orders a mental health evaluation to determine whether an individual meets the legal criteria for treatment under the state’s Mental Health Code. This form is completed by a qualified examiner—such as a psychiatrist, licensed psychologist, or physician—after conducting a personal examination of the individual. The examiner must document their observations, the individual’s behavior, and any relevant medical records or consultations, and then certify whether the person requires treatment. The form serves two main purposes. First, it provides a report to the court on whether a clinical certificate is warranted, stating if the person does or does not require treatment or hospitalization pending a hearing. Second, if warranted, it includes a clinical certificate, which details any diagnosed mental illness and explains how the illness affects the individual’s safety, ability to care for themselves, or willingness to engage in treatment. The examiner may also recommend hospitalization, assisted outpatient treatment, or a combination of both. Approved, SCAO. MCL 330.1400, MCL 330.1434, MCL 330.1435, MCL 330.1750. www.FormsWorkflow.com