Order Confirming Voluntary Admission {ME-922}

ME-922, 04/07 Order Confirming Voluntary Admission 24751.13(4), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF Name of Subject Date of Birth Order Confirming Voluntary Admission Case No. Based upon an allegations of the Petition for Review and any accompanying documents, THE COURT FINDS: There is a prima facia showing that the A. minor is in need of psychiatric services, or services for developmental disabilities, alcoholism, or drug abuse; B. facility the minor has been admitted to offers inpatient therapy or treatment that is appropriate C. facility is the least restrictive therapy or treatment consistent with the needs of the minor; D. minor is 14 years of age or older and has been admitted to the facility for the primary purpose of treatment for mental illness or developmental disabilities and the admission was made IT IS ORDERED: The voluntary admission of the minor is approved. DISTRIBUTION: 1. Court 2. Facility 3. Other: www.FormsWorkflow.com