FORM MH-406 Gc Order Granting Inpatient Authority

• Legal Form Number: FORM MH-406
• Date: 01 January 2022
• Section: AZ MH Forms Annotated

FORM MH-406

(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 for: __________

SUPERIOR COURT OF ARIZONA, __________ COUNTY

In the Matter of the Guardianship of [and Conservatorship for]: an Adult. NO. __________ ORDER GRANTING GUARDIAN MENTAL HEALTH POWERS AUTHORIZING CONSENT TO INPATIENT MENTAL HEALTH CARE AND TREATMENT INCLUDING PLACEMENT Hearing on __________at __________

Having considered the Petition for Authority to Consent to Inpatient Mental Health Care and Treatment Including Placement, the evaluation by the mental health expert, and evidence presented, the Court finds:

1. Guardian is entitled to file pursuant to A.R.S. § 14-5312.01(B).

2. Venue in this county is proper.

3. Notice was given as required by law.

4. Clear and convincing evidence that (subject person's name) is an incapacitated person and as a result of a mental disorder as defined by A.R.S. § 36-501(25) is likely to need inpatient mental health care and treatment within the next year.

IT IS ORDERED:

A. Guardian has the authority, pursuant to A.R.S. §§ 14-5312 and -5312.01(B), to consent for [subject person's name] 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 the medical, psychiatric, and psychological treatment associated with that placement, subject to the following restrictions: .

B...