Form JV-222 "Input on Application for Psychotropic Medication" - California

What Is Form JV-222?

This is a legal form that was released by the California Superior Court - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2018;
  • The latest edition provided by the California Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form JV-222 by clicking the link below or browse more documents and templates provided by the California Superior Court.

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Download Form JV-222 "Input on Application for Psychotropic Medication" - California

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Input on Application for
Clerk stamps date here when form is filed.
JV-222
Psychotropic Medication
If you do not agree that the child should take the recommended psychotropic
medication and/or continue the psychotropic medication that the child is
currently taking, or if you wish to tell the court something about the child or
medication, complete this form and file it with the court within four court days
of receiving notice of the pending application for psychotropic medication.
Read form JV-217-INFO, Guide to Psychotropic Medication Forms, for more
information about the required forms and the application.
Child’s name:
Fill in court name and street address:
(first)
(middle)
(last)
Superior Court of California, County of
Your name:
1
(last)
(first)
(middle)
2
Your relationship to the child:
Attorney
Caregiver
CASA
Indian Tribe
Legal Guardian
Parent
Fill in child's name and date of birth:
Other (explain):
Child's Name:
3
How long have you known the child?
Date of Birth:
(days)
(years)
(months)
Court fills in case number when form is filed.
Case Number:
4
How long has the child lived in your home or facility?
(months)
(days)
(years)
The child does not live with me.
The application is opposed because:
5
Judicial Council of California, www.courts.ca.gov
JV-222,
Page 1 of 2
Input on Application for
Revised January 1, 2018, Optional Form
Welfare and Institutions Code, §§ 369.5, 739.5
Psychotropic Medication
California Rules of Court, rule 5.640
Input on Application for
Clerk stamps date here when form is filed.
JV-222
Psychotropic Medication
If you do not agree that the child should take the recommended psychotropic
medication and/or continue the psychotropic medication that the child is
currently taking, or if you wish to tell the court something about the child or
medication, complete this form and file it with the court within four court days
of receiving notice of the pending application for psychotropic medication.
Read form JV-217-INFO, Guide to Psychotropic Medication Forms, for more
information about the required forms and the application.
Child’s name:
Fill in court name and street address:
(first)
(middle)
(last)
Superior Court of California, County of
Your name:
1
(last)
(first)
(middle)
2
Your relationship to the child:
Attorney
Caregiver
CASA
Indian Tribe
Legal Guardian
Parent
Fill in child's name and date of birth:
Other (explain):
Child's Name:
3
How long have you known the child?
Date of Birth:
(days)
(years)
(months)
Court fills in case number when form is filed.
Case Number:
4
How long has the child lived in your home or facility?
(months)
(days)
(years)
The child does not live with me.
The application is opposed because:
5
Judicial Council of California, www.courts.ca.gov
JV-222,
Page 1 of 2
Input on Application for
Revised January 1, 2018, Optional Form
Welfare and Institutions Code, §§ 369.5, 739.5
Psychotropic Medication
California Rules of Court, rule 5.640
Case Number:
Child’s name:
The application is not opposed, but I want to tell the court the following:
6
7
I am the attorney for the child.
a.
I need more time to investigate the application.
b.
I need the following information to determine whether to agree with or oppose the application:
c.
There is other information the judge should know:
8
Additional information about the child for the court to consider is included on an attached sheet or sheets of
paper. (Write "Attachment 5" on top.)
Date:
Sign your name
Type or print name
Rev. January 1, 2018
JV-222,
Input on Application for
Page 2 of 2
Psychotropic Medication
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