CONFIDENTIAL COURT RECORD ME-951, 02/16 Order Regarding Voluntary Admission (24751.10(4m)) 24751.10(4m), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. The admitting physician and guardian ad litem appeared at a hearing which was held on [Date] . The patient appeared. waived appearance. THE COURT FINDS AND ORDERS: 1. The patient was admitted to the facility less than seven (7) days prior to the hearing and has not signed a voluntary admission application. 2. A. The patient desires to leave the facility and shall be discharged, subject to any subsequently filed involuntary commitment proceedings. B. The patient has not expressed a desire to leave the facility and is found to be voluntarily admitted to the facility. DISTRIBUTION: 1. Court 2. Facility 3. Guardian ad Litem 4. Patient 5 . Other: STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF Name of Patient Date of Birth Order Regarding Voluntary Admission Case No. American LegalNet, Inc. www.FormsWorkFlow.com