In Vermont, the emergency examination of a person believed to be in need of treatment under 18 V.S.A. section 7504 begins with this application, captioned in the Superior Court, Family Division. A clinician meets it when acting as the applicant, often alongside a physician's first certification. The application sets out observed and reliably reported facts showing why the person needs an emergency examination and hospitalization.
The applicant completes the whole form and signs it. The form notes that only a law enforcement officer or a mental health professional (physician, psychologist, social worker, mental health counselor, nurse or other qualified person designated by the Commissioner of Mental Health) may apply for a warrant for an emergency examination.
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Application for Emergency Exam
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The form says only a law enforcement officer or a mental health professional may apply for a warrant for an emergency examination. Mental health professionals include physicians, psychologists, social workers, mental health counselors, nurses and other qualified persons designated by the Commissioner of Mental Health.
A copy of the application must travel with the person, together with either the physician's first certificate or, when a physician's certificate is not available without serious and unreasonable delay, a warrant from a superior court judge. A copy also goes to the VPCH Admissions Office.