Forms

• Schedules
• Mental Health Act Forms
• Sentencing Act Forms
• Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 Forms

Schedules

The Mental Health Regulations 1998 prescribe forms in the schedules to the Regulations for the purpose of giving effect to the Mental Health Act 1986

The files below are in Portable Document format - file size is in brackets

• Schedule 1 - Request for a person to receive involuntary treatment from an approved mental health service (143KB) September 2008
• Schedule 2 - Recommendation for a person to receive involuntary treatment from an approved mental health service (160KB) September 2008
• Schedule 3 - Authority to transport without recommendation (128KB) September 2008
• Schedule 4 Form 1 - Restraint for the purposes of safely transporting a person to an approved mental health service (142KB) September 2008
• Schedule 4 Form 2 - Sedation for the purposes of safely transporting a person to an approved mental health service (142KB) September 2008
• Schedule 6 - Involuntary treatment order (156KB) September 2008
• Schedule 21- Register of major non-psychiatric treatment (112KB)September 2008
• Electroconvulsive therapy monthly return (October 2008) - this form requires a login and password to access

Mental Health Act Forms

The files below are in Portable Document format - file size is in brackets

• MHA1 - Examination of involuntary patient by authorised psychiatrist (122KB) December 2005
• MHA2 - Transport of person subject to involuntary treatment order to an approved mental health service (139KB) September 2008
• MHA3 - Examination of security / involuntary / forensic patient by authorised psychiatrist (125KB) October 2006
• MHA4 - Treatment plan (125KB) December 2004 also available in A4 size (see below)
• MHA4 - Treatment plan A4 size (249KB) December 2004
• MHA5 - Appeal to the Mental Health Review Board (111KB) October 2006
• MHA6 - Community treatment order (117KB) December 2004
• MHA7 - Progress report on community treatment order (105KB) December 2004
• MHA8 - Variation of community treatment order (125KB) December 2004
• MHA9 - Extension of community treatment order (117KB) December 2004
• MHA10 - Revocation of community treatment order (143KB) September 2008
• MHA11A - Restricted community treatment order (125KB) October 2006 - to be used for people subject to restricted involuntary treatment orders
• MHA12A - Progress report on restricted community treatment order (113KB) October 2006 - to be used for people subject to restricted involuntary treatment orders
• MHA13A - Variation of restricted community treatment order (113KB) October 2006 - to be used for people subject to restricted involuntary treatment orders
• MHA15A - Revocation of restricted community treatment order (143KB) September 2008 - to be used for people subject to restricted involuntary treatment orders
• MHA16 - Discharge from involuntary patient status (124KB) December 2004
• MHA17A - Discharge from restricted involuntary treatment order / assessment order / diagnosis, assessment and treatment order (126KB) October 2006
• MHA18 - Discharge of security / involuntary patient (125KB) October 2006
• MHA19 - Transfer of an involuntary patient to another approved mental health service (125KB) October 2008
• MHA20 - Transfer of a security / involuntary / forensic patient by chief psychiatrist (125KB) October 2008
• MHA21 - Leave of absence for an involuntary patient (124KB) October 2008
• MHA22 - Special leave of absence for a security patient (114KB) October 2006
• MHA23 - Authority to apprehend involuntary / security / forensic patient (153KB) September 2008
• MHA24 - Informed consent to electroconvulsive therapy (126KB) December 2004
• MHA25 - Authority to perform electroconvulsive therapy where informed consent not obtained (125KB) December 2004
• MHA26 - Informed consent to major non-psychiatric treatment (125KB) December 2004
• MHA27 - Substitute consent to non-psychiatric treatment (113KB) December 2004
• MHA28 - Approval / authority for mechanical restraint (116KB) January 2007 also available in A4 size (see below)
• MHA28 - Approval / authority for mechanical restraint A4 size (232KB) January 2007
• MHA28A - Mechanical restraint clinical observations (79KB) January 2007
• MHA29 - Mechanical restraint register - October 2005. This form is now printed from the CMI/RAPID database.
• MHA30 - Approval / authority for seclusion (115KB) January 2007 also available in A4 size (see below)
• MHA30 - Approval / authority for seclusion A4 size (229KB) January 2007
• MHA30A - Seclusion clinical observations (87KB) January 2007
• MHA31 - Seclusion register - October 2005. This form is now printed from the CMI/RAPID database.
• MHA32 - Annual examination of patient (113KB) December 2004 also available in A4 size (see below)
• MHA32 - Annual examination of patient A4 size (224KB) December 2004
• MHA33 - Notice of death of person undergoing treatment or care for a mental disorder (137KB) October 2008 also available in A4 size (see below)
• MHA33 - Notice of death of person undergoing treatment or care for a mental disorder A4 size (247KB) October 2008
• MHA34 - Certificate of psychiatrist (109KB) October 2006
• MHA35 - Report of authorised psychiatrist (105KB) October 2006
• MHA36 - Transfer order of an involuntary patient to an interstate mental health facility (117KB) October 2008

Sentencing Act 1991 Forms

The files below are in Portable Document format - file size is in brackets

• Form 4A- Certificate of Psychiatrist for diagnosis, assessment and treatment order (65KB) January 2007
• Form 4B- Certificate of Psychiatrist for restricted involuntary treatment order (65KB) January 2007
• Form 4C - Certificate of Psychiatrist for hospital security order (65KB) January 2007
• Form 5A - Report of authorised pyschiatrist for diagnosis, assessment and treatment order (77KB) January 2007
• Form 5B - Report of authorised psychiatrist for restricted involuntary treatment order (77KB) January 2007
• Form 5C - Report of authorised psychiatrist for hospital security order (77KB) January 2007

Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 Forms

Quarterly Clinical Report - Non-Custodial Supervision Order - Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 - March 2008 (Word file 78KB)