en-USIn the matter of en-US 1. þ This court has received your objection to hospitalization/admission without a hearing and will conduct a hearing to decide þ whether you need to be in a hospital or facility. If this court agrees, you will be allowed to leave. 2. þ A hearing on your objection will be held at: þ en-USLocation þ en-USDate Time þ before Judge en-USBar no. 3. þ You are entitled to be represented by an attorney. The court has appointed: þ en-USAttorney name Bar no. þ en-USAddress þ en-USCity, state, zip Telephone no. þ If you desire to employ an attorney of your own choice, you may do so. If you prefer an attorney other than the one appointed þ for you, and the preferred attorney agrees to accept the employment and notifies the court of his/her appearance on your þ behalf, the court will replace the attorney now appointed for you. If you feel you are unable to pay for an attorney, and the þ court agrees, the court will see that your attorney is paid from public funds at the court approved rate. 4. þ You have the right to be present at the hearing. If you fail to attend the hearing after having an opportunity to meet with your þ attorney, you will be considered to have waived your right to attend and the hearing may be held without you. 5. þ For administrative admission only en-US(applies to individuals with developmental disability)en-US: You may also ask for an independent medical þ or psychological evaluation. If you feel you are unable to pay for this, and the court agrees, the court will see that the þ evaluation is paid for from public funds. You should discuss the need for an independent medical or psychological evaluation þ with your attorney. 6. þ You should discuss your rights with your attorney. en-USDate þ en-USDeputy probate register/clerk American LegalNet, Inc. www.FormsWorkFlow.com