Physicians Statement-Attachment {JV-220(A)}

JV-220(A), Physician’s Statement—Attachment, this form is used by the doctor to request a new court order for psychotropic medication for a child in foster care. The prescribing doctor fills this out then gives it to the person who files the Application (form JV-220). This form must be completed and signed by the prescribing physician. Read form JV-217-INFO, Guide to Psychotropic Medication Forms, for more information about the required forms and the application process. Judicial Council of California Revised January 1, 2018, Mandatory Form Welfare and Institutions Code, §§ 369.5; 739.5 California Rules of Court, rule 5.640 www.FormsWorkflow.com