Fill and Sign the Summary Hearing Form

(COURT SEAL) STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Amended IN THE MATTER OF Summary Hearing Findings and Order Continuing Order Authorizing Involuntary Administration of Psychotropic Medications (Annual Review) Name Date of Birth Case No. A Petition for Annual Review of Order Authorizing Involuntary Administration of Psychotropic Medications was filed. After consideration of the reports and other documents on file, all factors required by the statute, and such additional information presented; The Court has determined not to order to order additional information, and not to appoint to appoint adversary counsel. All requests for a full due process hearing of this Petition were withdrawn. The Court ordered and held a summary hearing. The Court ordered and held a full due process hearing. THE COURT FINDS: The ward continues to meet the standards for an Order for Involuntary Administration of Psychotropic Medications found under §55.14(8), Wis. Stats.  A physician has prescribed psychotropic medication for the ward.  The ward is not competent to refuse psychotropic medication.  One of the following is true:  The ward has refused to take the psychotropic medication voluntarily, OR  Attempting to administer psychotropic medications to the ward voluntarily is not feasible or is not in the best interests of the ward.  The ward's condition for which psychotropic medication was prescribed is likely to be improved by administration of psychotropic medication and the ward is likely to respond positively to psychotropic medication.  Unless psychotropic medication is administered involuntarily, the ward will incur a substantial probability of physical harm, impairment, injury, or debilitation or will present a substantial probability of physical harm to others. THE COURT ORDERS: Continuation of the Order Authorizing Involuntary Administration of Psychotropic Medications and current treatment plan. THIS IS A FINAL ORDER FOR THE PURPOSE OF APPEAL IF SIGNED BY A CIRCUIT COURT JUDGE. DISTRIBUTION: 1. Court 2. Ward 3. Ward’s Guardian 4. Ward’s Legal Counsel, if any 5. Guardian ad Litem 6. Facility in which the ward resided when petition for annual review was filed 7. County Department of ward’s county of residence under §55.18(1)(a) 8. County Department of ward’s placement under §55.18(1m) 9. Other: GN-4270, 05/19 Summary Hearing Findings and Order Continuing Order Authorizing Involuntary Administration of Psychotropic Medication This form shall not be modified. It may be supplemented with additional material. Page 1 of 1 §55.19(3), Wisconsin Statutes