Order Regarding Application For Psychotropic Medication
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Order Regarding Application For Psychotropic Medication Form. This is a California form and can be use in Juvenile Judicial Council.
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Tags: Order Regarding Application For Psychotropic Medication, JV-223, California Judicial Council, Juvenile
JV-223
Order Regarding Application for
Psychotropic Medication
Clerk stamps date here when form is filed.
The Court read and considered:
a. JV-220, Application Regarding Psychotropic Medication, and JV-220(A),
Prescribing Physician's Statement—Attachment, filed on (date):
b.
JV-222, Opposition to Application Regarding Psychotropic
Medication, filed on (date):
c.
Other (specify):
Fill in court name and street address:
The Court finds and orders:
Superior Court of California, County of
a.
Notice requirements were met.
b.
1
Notice requirements were not met. Proper notice was not given to:
Fill in child's name and date of birth:
2
The matter is set for hearing on (date):
at (time):
Child's Name:
in (dept.):
Date of Birth:
Application was made for authorization to begin or to continue giving
the child the psychotropic medication listed in 15 on page 3 of
JV-220(A).
A copy of page 3 is attached to this order.
3
The application is (check one):
a.
granted as requested.
b.
Fill in case number when form is filed.
Case Number:
.
granted with the following modification or conditions to the request as made in
15
on the attached
page 3 of JV-220(A) (specify all modifications and conditions):
c.
denied (specify reason for denial):
Other (specify):
4
This order is effective until terminated or modified by court order or until 180 days from the date of this
order, whichever is earlier. If the prescribing physician is no longer treating the child, this order extends to
subsequent treating physicians. A change in the child’s placement does not require a new order regarding
psychotropic medication. Except in an emergency situation, a new application must be submitted and
consent granted by the court before giving the child medication not authorized in this order or increasing
medication dosage beyond the maximum daily dosage authorized in this order.
Date:
Signature of judge or judicial officer
Judicial Council of California, www.courtinfo.ca.gov
New January 1, 2008, Mandatory Form
Welfare and Institution Code, § 369.5
California Rules of Court, rule 5.640
Order Regarding Application for
Psychotropic Medication
JV-223, Page 1 of 1
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