Approved, SCAO OSM CODE: MOD STATE OF MICHIGAN FILE NO. PROBATE COURT ORDER TO MODIFY COUNTY SECOND OR CONTINUING ORDER CIRCUIT COURT - FAMILY DIVISION In the matter of 1. Date of Hearing: Judge: second Bar no.2. This court issued a continuing order on directing the above named individual Date of continued treatment order to undergo a program of alternative treatment or combined hospitalization and alternative treatment not to exceed one year. 3. The court has been notified that: the individual is not complying with the order. alternative treatment has not been or will not be sufficient to prevent harm or injury the individual may inflict upon self or others. the individual believes that the alternative treatment program is not appropriate. 4. THE COURT FINDS: IT IS ORDERED: 5. The one year order is modified and the individual shall undergo a program of alternative treatment under the supervision community mental health services program of a mental health agency or professional as follows: This alternative treatment shall not exceed one year from the date of issuance of the one year order. 6. The one year order is modified and the individual shall be hospitalized at for the remainder of the initially ordered one year, or 90 days, or for the remainder of the 90 day hospitalization portion of the one year order, whichever is shortest. Do not write below this line - For court use only PCM 217b (9/03) ORDER TO MODIFY SECOND OR CONTINUING ORDER MCL 330.1475, MCR 5.744>>>> 2 7. The one year order is modified and the individual shall continue to undergo combined hospitalization and alternative treatment for the remainder of the initially order one year. The individual shall be hospitalized at for a period not to exceed the remainder of the initially ordered one year period, or 90 days, or for the remainder of the 90 day hospitalization portion of the one year order, whichever is shortest. Alternative treatment shall be under the supervision of community mental health services program a mental health agency or professional as follows: NOTICE: The court must be promptly notified of the individuals release from the hospital to the alternative treatment program along with a psychiatrists statement that the individual is clinically appropriate for alternative treatment. 8. If the individual refuses to comply with a psychiatrists order to return to the hospital, a peace officer shall take the individual into protective custody and transport the individual to the hospital designated by the psychiatrist. 9. This order expires on . Note: No later than the 90 day period of the initial order. Date Date Judge NOTICE OF RIGHT TO OBJECT TO HOSPITALIZATION 1. This court has ordered you to be hospitalized rather than continue in an alternative treatment program. 2. You have a right to object to this hospitalization. If you wish to object, notify the County Probate Court. Complete the objection below and send a copy to the court. PROOF OF SERVICE I certify that this notice was personally served on the above individual on Date at Time m.and a copy mailed to the Court on Date . Signature OBJECTION TO HOSPITALIZATION I object to my hospitalization and request that the court schedule a hearing on the objection. Date Signature