FORM MH-401 GC motion to renew inpatient

• Legal Form Number: FORM MH-401
• Date: 01 January 2014
• Section: Az Mh Forms Annotated

FORM MH-401

[Attorney’s name, State Bar No.]

[Attorney’s law firm name]

[Law firm bar number]

[Address]

[Phone number]

[Attorney or firm’s e-mail address]

Attorney(s) for: __________

SUPERIOR COURT OF ARIZONA, __________ COUNTY

In the Matter of the Guardianship of [and Conservatorship for]: An Adult. NO. __________ MOTION TO RENEW INPATIENT MENTAL HEALTH CARE AND TREATMENT AUTHORITY

Pursuant to Rule 36(A)(1), Ariz. R. Prob. P., Guardian, _______, requests an order renewing his or her authority to consent for Ward to receive inpatient mental health care and treatment, including placement in a level one behavioral health facility licensed by the Arizona Department of Health Services and medical, psychiatric, and psychological treatment associated with such placement. Guardian states:

1. On [appointment date], the Court appointed Guardian.

2. On [date], Guardian was granted authority to consent for Ward to receive inpatient mental health care and treatment, including placement in a level one behavioral health facility licensed by the Arizona Department of Health Services and medical, psychiatric, and psychological treatment associated with placement pursuant to A.R.S. §...