Fill and Sign the Criteria for Involuntary Commitment in North Carolina Unc Form

You have been committed after (a) being charged with a violent crime and being found incapable of proceeding or (b) being found not guilty by reason of insanity. T he physician now treating you has determined that f urther treatment is not necessary. However, you may not b e released without the hearing referred to below. The physician now treating you has determined that you are in need of further care and treatment beyond your present period of commitment. It has been alleged that you are a substance abuser and a proper subject for involuntary commitment. PM AM 1. 4. 2. 3. It has been alleged that you are mentally ill and a proper subject for involuntary commitment. outpatient inpatient NOTICE TO THE RESPONDENT NAMED ABOVE (Check only one) A hearing will be held before a district court judg e at the date, time and place indicated below. At that hearing it will be determined if you should be committed, released, or recommitted for treatment. At this hearing you will be allowed to present evidence. If the hearing is for inpatient commitment o r for commitment as a substance abuser, you have a right to be represente d by an attorney. If you cannot afford an attorney, one will be appointed for you. If the hearing is for an outpatient commitment, you may hire an attorney to represent you. If you cannot afford an attorney, you may ask the court to appoint one for you. However, the court may or may not appoint an attorney based upon the facts in your particular case. Time Of Hearing Place Of Hearing Date Of Hearing Deputy CSC Assistant CSC Clerk Of Superior Court Signature This Notice must be served on the respondent at lea st seventy-two (72) hours before the hearing. NOTICE TO SHERIFF Date Date Of Birth STATE OF NORTH CAROLINA Original-File Copy-Petitioner Copy-Respondent Copy-Attorney (Over) File No. In The General Court Of Justice District Court Division County IN THE MATTER OF: NOTICE OF HEARING/REHEARING FOR INVOLUNTARY COMMITMENT G.S. 122C-264, -274, -276, -284, -292 AOC-SP-301, Rev. 3/02 2002 Administrative Office of the Courts Name And Address Of Respondent Service Accepted By Attorney For Respondent 1. 2. I certify that this Notice was received and served on the respondent as follows: Name Of Person With Whom Copies Left Address Where Copies Delivered Or Left Date Served Respondent WAS NOT served for the following reason: Deputy CSC Assistant CSC Clerk Of Superior Court AM PM Deputy Sheriff Making Return By delivering to the respondent named above a copy of this Notice. By leaving a copy of this Notice at the respondent' s dwelling house or usual place of abode with a per son of suitable age and discretion then residing therein. CLERK'S CERTIFICATION OF SERVICE AOC-SP-301, Side Two, Rev. 3/02 2002 Administrative Office of the Courts RETURN OF SERVICE NOTE TO CLERK: (In Addition To Service On Respondent) For cases in which the examiner recommends inpatient commitment for a person wh o is mentally ill: The clerk in the county where the 24-hour facility is located must deposit in the mail a copy of this Notice by first-class mail at least 72 hours before the hearing to the respondent's counsel and th e petitioner, unless the petitioner has waived his/her right to notice on form AOC-SP-300. If the respondent has been found not guilty by reason of insanity or has been charged with a violent crime and bee n found incapable of proceeding, the clerk must also mail a copy of the notice to the chief district court judge and the district attorney in the county in which the defendant was found not guilty by reaso n of insanity or incapable of proceeding. For cases in which the examiner recommends outpatient commitment for a person who is mentally ill: The clerk in the county where the petition was initiated must deposit in the mail a copy of this Notice by first-class mail at least 72 hours before the hearing to the proposed outpatient treatment cent er or physician and the petitioner, unless the petitioner has waived h is/her right to notice. If the respondent was charged with a violent crime and found incapable of proceeding, see instructions immediately above for additional persons to be served. For cases in which the examiner finds that the respondent is a substance abuser: The clerk in the county where the facility is located if respondent is held in a 24-hour facility or the clerk in the county where the petition was initiated if not held in a 24-hour facility must deposit in the mail a copy of this Notice by first-class mail at least 72 hours before the hearing to the respondent's counsel and the petitioner, unless th e petitioner has waived his/her right to notice. Notice should also be sent to the area authority or physician that will be responsible for the commitment. I certify that I have mailed copies of this Notice by first class mail at least 72 hours before the he aring to the persons whose name and address are listed below (fill in on ly those appropriate): Name Of Respondent Name And Address Of Petitioner Name And Address Of Proposed Outpatient Treatment Center/Physician County Date Received Date Returned Date Signature Time Served Signature Date Accepted Name And Address Of Area Authority/Physician Name And Address Of Counsel For Respondent Name Of Sheriff