Certificate Of Examination {CCCO 0110}

CCCO 0110 - CERTIFICATE OF EXAMINATION. This form is used in the Circuit Court of Cook County, Illinois, in the County Department, County Division which documents the examination of an individual for mental illness, mental retardation, or both, and whether they pose a danger to themselves or others. The examination is usually ordered by the court, but it can also be conducted on an emergency basis. The form requires the examiner to provide their opinion on the individual's clinical condition and need for services, based on the examination conducted at a specific time and location. The examiner must also indicate whether they believe the individual is subject to involuntary admission, and if so, whether inpatient hospitalization or an alternative mental health facility or program is appropriate. The form is signed by the examiner, who must be a qualified professional, such as a psychiatrist, physician, qualified examiner, or clinical psychologist. www.FormsWorkflow.com