Statute · California Welfare and Institutions Code
Cal. Welf. & Inst. Code § 6253 — Definitions, Construction and Standard Forms
Cal. Welf. & Inst. Code § 6253
- Type
- Statute
- Source
- California Welfare and Institutions Code
- Jurisdiction
- California
- Current through
- Nov 2, 2026 (California Legislative Counsel)
Wherever provision is made in this code for court-appointed medical examiners to make and sign a certificate showing the facts of an examination in the case of a person alleged to be subject to judicial commitment, the certificate shall be in substantially the following form:
Citator
Cal. Welf. & Inst. Code § 6253 — Definitions, Construction and Standard Forms is in force in the current edition of the Code, and nothing recorded condemns it.
Wherever provision is made in this code for court-appointed medical examiners to make and sign a certificate showing the facts of an examination in the case of a person alleged to be subject to judicial commitment, the certificate shall be in substantially the following form:
In the Superior Court of the State of California
for the County of ________
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In the Superior Court of the State of California |
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__________ |
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The People
For the Best Interest and Protection of __________, |
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as a __________ and |
⎬ |
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⎪ |
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Concerning __________, |
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and __________, |
⎪ |
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__________Respondents __________ |
⎪ |
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We, Dr. ________ and Dr. ________, medical examiners in the County of ________, duly appointed and certified as such, do hereby certify under our hands that we have examined ________, alleged to be a ________, and have attended before a judge of said court at the hearing on the petition concerning said person, and have heard the testimony of all witnesses, and, as a result of the examination, have testified under oath before the court to the following facts concerning the alleged ____________: |
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Name __________ Address __________ Age __________ Sex __________ Occupation __________ Marital status __________ (Single, married, widowed, divorced) Religious belief __________ Pertinent case history __________ __________ __________ General physical condition __________ __________ Present mental status __________ __________ __________ Laboratory reports (if any) __________ __________ Tentative diagnosis of mental health __________ __________ __________ Recommendation for disposition or supervision, treatment and care __________ __________ __________ Reason for the recommendation __________ __________ __________ __________ |
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Date ________________ |
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____________________Medical Examiner ____________________Medical Examiner |
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