MONTANA JUDICIAL DISTRICT COURT, COUNTY

* CAUSE NO.

IN THE MATTER OF *

* JUDGE

, *

* ORDER SETTING DATE AND

Respondent. * TIME FOR HEARING ON

* PETITION FOR COMMITMENT

* TO MENTAL HEALTH FACILITY

* * * * * * * * * * * * * * * * & ORDER OF DETENTION

A Petition having been filed with this Court on the

day of , 19 , by , County Attorney, alleging that the Respondent is a seriously mentally ill person within County, Montana, and asking that the Respondent be committed to a mental health facility for period of not more that days, and asking that the Respondent be detained at Hospital pending hearing on this matter; and Respondent shall appear before this Court on the day of , 19 , at

o'clock .m., with counsel; and the Court shall advise the Respondent of his rights and the substantive effectof the above-mentioned Petition; and the Court having been fully advised now makes the following Findings and Order:

FINDINGS

THE COURT HEREBY FINDS:

1. That probably cause exists that the Respondent is a seriously mentally ill person in County, Montana.

2. That probable cause exists for detention of the Respondent at Hospital pending hearing of this matter.

3. That the Respondent has not expressed a preference as to the choice of a responsible person; and that choice, if any is:

NAME ADDRESS

4. That is suitable to be Respondent's Responsible Person.

ORDER

IT IS HEREBY ORDERED AS FOLLOWS:

1. That is appointed as Responsible Person.

2. That Dr. is appointed as Professional Person.

3. That Respondent be examined by the Professional Person without unreasonable delay for a period not exceeding

hours; and that the Professional Person immediately notify the County Attorney of his findings in person or byphone and make a written report of his examination to this Court, with copies to the Respondent's attorney and the Petitioning County Attorney pursuant to law.

4. The hearing on this matter shall be held on the day of , 19 , at o'clock .m., in the courtroom of the County Courthouse, , Montana.

5. That is appointed as attorney for Respondent.

6. That the Respondent be detained at Hospital, Stress Unit, pending the above-scheduled hearing, and that he continue to be treated and evaluated unless Respondent's counsel makes a formal objection to this Court.

DATED this day of , 19 .

(SEAL) District Court Judge