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Fill and Sign the Wisconsin Defect Form

Fill and Sign the Wisconsin Defect Form

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STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use State of Wisconsin, Plaintiff -vs-       , Defendant Name Order for Examination under 971.17(4)(c) (Not Guilty by Reason of Mental Disease or Defect)       Date of Birth Case No.       Defendant’s: Telephone Number       Address       Present Location       THE COURT FINDS: 1. The defendant was committed to the Department of Health and Family Services (DHFS) on (date)       . A copy of the Order of Commitment is attached. 2. A petition for conditional release of the defendant has been filed by the defendant. director of the mental health facility at which the defendant is committed. THE COURT ORDERS: 1. The defendant be examined by (name)       to determine if the defendant is appropriate for conditional release. 2. The examiner report on the type of treatment and services needed by the defendant while on conditional release in the community if the examiner believes the defendant is appropriate for conditional release. 3. All of the defendant’s treatment records requested by the examiner be released to the examiner. 4. The clerk provide the examiner a copy of the most recent criminal complaint and all other examiner’s report(s). 5. The report be furnished to the court no later than (date)       . 6. A hearing be held on (date)       at (time)       . 7. Other:       Distribution: 1. Court – Original 2. District Attorney 3. Defense Attorney 4. Examiner 5. Department of Health and Family Services 6. Mental Health Institute 7. Defendant BY THE COURT: Circuit Court Judge/Clerk of Court       Name Printed or Typed       Date CR-277 , 05/04 Order for Examination under 971.17(4)(c) (Not Guilty by Reason of Mental Disease or Defect) Wis. Stats. §971.17(4)(c) This form shall not be modified. It may be supplemented with additional material.

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