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Get and Sign Jv220a Form 2016
Medication or to increase the maximum dose of a previously approved medication
b.
A request to continue psychotropic medication the child is currently taking
c.
3
This application is made during an emergency situation as defined in California Rules of Court, rule 5.640(g).
The emergency circumstances requiring the temporary administration of psychotropic medication pending the
court’s decision on this application are:
4
Prescribing physician:
a. Name:
b. Address:
c. Phone numbers:
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