Latest version: 3.0.1 (updated August 2024)
Petition: Also called the affidavit, the Petition document explains why the patient is a danger to self/others. We usually complete it, but a layperson (family member, friend, etc.) can go to the magistrate's office and fill it out, too. The purpose of the Petition is to ask the magistrate to issue a Custody Order.
Custody Order: The Custody Order is issued by the magistrate and given to law enforcement to "serve" to the patient. Once the patient has been served by law enforcement, this document gives us the right to hold the patient in the ED and transfer them to an inpatient unit. If a layperson does the Petition for a person not already at the hospital, the Custody Order also allows police to take the respondent into custody and bring them to a hospital for a psychiatric evaluation. A copy of this document will end up in the patient's paper chart.
First Exam: Also called the First Opinion, the First Exam is completed by you, the professional. It notifies the court that, based on your assessment, the patient meets IVC criteria. If a patient is still awaiting inpatient psych placement after 7 days and continues to meet IVC criteria, you must re-petition the patient and complete another First Exam.
Second Exam: The Second Exam must be completed by a physician within 24 hours of admission to an inpatient psychiatric floor. That time clock starts once the patient arrives at an inpatient unit such as 1SA. It must be completed by a different physician than the one that completed the First Exam. It is never completed in the emergency department.
Emergency Commitment: Technically called Supplement to Support Immediate Hospitalization and sometimes referred to as a “24 hour hold form,” this process bypasses the magistrate and acts as the custody order, allowing for immediate transfer to an inpatient psychiatry unit. It must be notarized and used in conjunction with the First Exam.
Why do I have to use Adobe Reader?
Because the built-in web browser viewers (i.e., Chrome, Internet Explorer) do not fully support all the features in the PDF.
Why does the IVC button skip past the petition and go straight to the first exam?
Because it's easier to fill out this way, as the information you put in will fill "up." It will print as normal. The Petition and First Exam are still two separate documents. This is purely technical for efficiency.
Which documents should be notarized?
Only the Petition and Emergency Commitment. The first and second exams do not need to be notarized.
What if a patient comes in already under petition?
Just do the First Exam. Don't petition them again because it creates two court files for the same patient. Follow the flowchart for direct guidance.
What paperwork is sent to the magistrate?
Only the Petition and First Exam (which are bundled together). The role of the magistrate is to review Petitions and issue Custody Orders. If the patient is already under petition, don't submit anything else to them. Everything else goes to the Clerk of Court.
Where can I find additional training on IVC commitment criteria?
You can watch an excellent one-hour lecture from Mark Botts at UNC School of Government here. PAs, NPs, therapists, and social workers who wish to complete First Examinations may do by obtaining the First Level Commitment Examiner Certification. This certification involves 10-12 hours of online training, exam, and supervision of three evaluations.
Something's not working right.
Sure, just email me and let me know and I'll get it fixed. You can always access the state forms directly over here.
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