Fill and Sign the State of Wisconsin Circuit Court Dane County Published Form

CR-272, 08/12 Order for Predisposition Investigation (Not Guilty by Reason of Mental Disease or Defect) §51.30(1)(b), 146.82(2)(c), 971.17(2), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional mater ial. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY State of W isconsin, Plaintiff -vs - , Defendant Name Date of Birth Order for Predisposition Investigation (Not Guilty by Reason of Mental Disease or Defect) Case No. Defendant’s: Present Location (Include municipality and county) THE COURT FINDS: 1. The defendant was committed to the Department of Health Services (DHS) on [D ate] . A copy of the Order of Commitment is attached. 2. The court lacks sufficient information to determine whether the commitment should be for i nstitutional care or conditional release. THE COURT ORDERS: 1. DHS to conduct a predisposition investigation and prepare a report to assist the court in framing a placement order under the commitment. 2. All the defendant’s treatment records requested by the investigator be released to the investigator. 3. The report be furnished to the court no later than [Date] . 4. A hearing be held on [Date] at [Time] a.m . p.m . Additional information or concerns, if any: THIS IS A FINAL ORDER FOR PURPOSES OF APPEAL IF SIGNED BY A CIRCUIT COURT JUDGE. BY THE COURT: DISTRIBUTION: 1. Court 2. District Attorney 3. Defendant/Attorney 4. Department of Health Services Circuit Court Judge/Clerk of Circuit Court Title (Print or Type Name if not eSigned) Date