IN THE CIRCUIT COURT OF _______________ COUNTY, WEST VIRGINIA IN RE: Involuntary Hospitalization of: Case No. ________- MH -________ ___________________________________ RESPONDENT ORDER: FOR DETENTION AND HEARING ON MOTION FOR INVOLUNTARY HOSPITALIZATION DUE TO NONCOMPLIANCE [W.Va. Code: §27-5-2(h)] [FOR HEARING TO BE HELD FORTHWITH] On the _______ day of ____________________, 20_____, came the movant, ________________________________ __________________________, who is (relationship to Respondent) ________________________________________ and moved this Court to order that the above-named Respondent be taken into custody and detained for the purposes of a hearing pursuant to the provisions of West Virginia Code: § 27-5-2 (h) for the failure or refusal of the Respondent to comply with the terms of the Voluntary Treatment Agreement. This Court FINDS the motion sets forth facts which are sufficient to meet the requirements for detention, custody and hearing as provided by West Virginia Code: § 27-5-2(h). Accordingly, it is ORDERED that the Sheriff of this County shall forthwith take into custody, detain, and thereafter bring the Respondent before this Court for the purpose of conducting a hearing upon said motion forthwith. The hearing shall be held at the following location: _______________________________________________________________________________________ ______________________________________________________________________________________________________ The Clerk shall enter the foregoing as of the date first above written and transmit attested copies thereof to the Sheriff of this County, to ____________________________________________ Mental Health Center/Treatment Provider, the Movant, and all counsel of record in this matter. ___________________________________________________________________ MAGISTRATE / MENTAL HYGIENE COMMISSIONER / CIRCUIT JUDGE SCA-MH 907D / 6-06 American LegalNet, Inc. www.FormsWorkflow.com