Get the free MHCTA-12 - Involuntary Certification Checklist.docx
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MENTALHEALTHCare&TreatmentActPLEASE INITIAL IN SPACES PROVIDED AND SIGN ATTACHED SIGNATURE KEY Involuntary Certification / Communications Checklist Location of Original: Person Arrived at Facility:
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How to fill out mhcta-12 - involuntary certification
How to fill out mhcta-12 - involuntary certification
01
Obtain an MHCTA-12 form from the appropriate mental health facility or agency.
02
Fill out the client and facility information at the top of the form.
03
Provide a brief description of the client's current mental health condition and the reasons for considering involuntary certification.
04
Document any known history of mental health treatment or previous involuntary certifications for the client.
05
Include any supporting documentation, such as medical records or witness statements, that provide evidence for the need for involuntary certification.
06
Sign and date the form, providing your name and contact information as the person completing the certification.
07
Submit the completed MHCTA-12 form to the appropriate mental health facility or agency for review and processing.
Who needs mhcta-12 - involuntary certification?
01
MHCTA-12 - involuntary certification is needed for individuals who meet specific criteria and pose a risk to themselves or others due to a severe mental health condition.
02
This certification allows for the involuntary commitment of individuals who cannot or will not seek mental health treatment voluntarily.
03
Typically, MHCTA-12 is used in situations where immediate intervention is required to protect the individual or others from harm caused by the individual's mental health condition.
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