Form JV-216 Order Delegating Judicial Authority Over Psychotropic Medication - California

Form JV-216 is a California Superior Court form also known as the "Order Delegating Judicial Authority Over Psychotropic Medication". The latest edition of the form was released in September 1, 2018 and is available for digital filing.

Download an up-to-date Form JV-216 in PDF-format down below or look it up on the California Superior Court Forms website.

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Order Delegating Judicial Authority
Clerk stamps date here when form is filed.
JV-216
Over Psychotropic Medication
Parent or legal guardian (name):
1
The court finds as follows:
2
a.
The parent or legal guardian poses no danger to the child.
b.
The parent or legal guardian has the capacity to authorize
psychotropic medications.
Fill in court name and street address:
Superior Court of California, County of
The parent or legal guardian in
1
is authorized to approve or deny the
3
administration of psychotropic medication for the child, unless such
authority is modified by a subsequently issued order.
Fill in child's name and date of birth:
Child's/Nonminor's Name:
Date of Birth:
Court fills in case number when form is filed.
Case Number:
Date:
(SIGNATURE OFJUDICIAL OFFICER )
Judicial Council of California, www.courts.ca.gov
JV-216,
Order Delegating Judicial Authority Over
Page 1 of 1
Revised September 1, 2018, Optional Form
Psychotropic Medication
Welfare and Institutions Code, §§ 369.5, 739.5
California Rules of Court, rule 5.640
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Print this form
Save this form
Clear this form
Order Delegating Judicial Authority
Clerk stamps date here when form is filed.
JV-216
Over Psychotropic Medication
Parent or legal guardian (name):
1
The court finds as follows:
2
a.
The parent or legal guardian poses no danger to the child.
b.
The parent or legal guardian has the capacity to authorize
psychotropic medications.
Fill in court name and street address:
Superior Court of California, County of
The parent or legal guardian in
1
is authorized to approve or deny the
3
administration of psychotropic medication for the child, unless such
authority is modified by a subsequently issued order.
Fill in child's name and date of birth:
Child's/Nonminor's Name:
Date of Birth:
Court fills in case number when form is filed.
Case Number:
Date:
(SIGNATURE OFJUDICIAL OFFICER )
Judicial Council of California, www.courts.ca.gov
JV-216,
Order Delegating Judicial Authority Over
Page 1 of 1
Revised September 1, 2018, Optional Form
Psychotropic Medication
Welfare and Institutions Code, §§ 369.5, 739.5
California Rules of Court, rule 5.640
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Print this form
Save this form
Clear this form

Download Form JV-216 Order Delegating Judicial Authority Over Psychotropic Medication - California

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