www.courts.ca.gov (specify): Guide to PsychotropicMedication Forms, (date): (check all that apply): (specify): (specify): (name): (provide name, professional status, and date of evaluation): American LegalNet, Inc. www.FormsWorkFlow.com (describe, specifying significant medical conditions, all current nonpsychotropic medications, date of last physical examination, and any recent abnormal laboratory results): Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5): American LegalNet, Inc. www.FormsWorkFlow.com (explain): (explain): (explain what laboratory tests were not done and why). (explain): American LegalNet, Inc. www.FormsWorkFlow.com Medication name (generic/brand) and symptoms targeted by each medication222s anticipated benefit to child Maximum total mg/day Treatment duration* 6-month maximumAdministration schedule *Authorization to administer the medication is limited to this time frame or six months from the date the order is issued, whichever occurs first. Signature of prescribing physician Type or print name of prescribing physician(check all that apply; include frequency for therapy on blank line): (explain): (explain):l. American LegalNet, Inc. www.FormsWorkFlow.com