New York OMH 471: Two-Physician Admission (9.27)

Involuntary psychiatric admission on medical certification under New York Mental Hygiene Law section 9.27 uses the OMH 471 packet. A clinician meets it when an applicant, such as a relative, a treating psychiatrist or a facility director, seeks admission and two examiners must certify that the person needs involuntary care. Each examiner completes a separate OMH 471A certificate, and either can request police or ambulance transport on the OMH 471B.

Who completes it

The applicant completes Part A of the OMH 471. Two examining physicians, or one physician and one psychiatric nurse practitioner, each complete an OMH 471A, and a hospital staff psychiatrist who was not an original examiner completes Part B before admission.

Submitting and payment

How to submit it
The application and certificates go to the admitting hospital; the examinations must be made within 10 days before admission. The forms may be signed electronically, including in the EHR, if they can be printed or delivered to the hospital, court and Mental Hygiene Legal Service.

Good to know

  • An examiner is disqualified if not licensed in New York, related to the applicant or patient, financially interested in the hospital, or on the staff of a proprietary hospital receiving the patient.
  • Telehealth, by audio-visual means only, may be used for just one of the three required examinations, after asking the person to consent.
  • Examiners must consider less restrictive alternatives and, where possible, consult the clinician who provided prior treatment.
  • If no hearing is requested, the hospital director may retain the patient up to 60 days; longer stays need a court order.

Get the official form

Download the current version from the source each time; forms change without notice.

Application for Involuntary Admission on Medical Certification (with Certificate of Examining Physician or Psychiatric Nurse Practitioner)

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Frequently asked questions

Can a nurse practitioner sign an OMH 471A?

Yes, for one of the two certificates. Admission under section 9.27 needs certificates from two examining physicians, or from one examining physician and one psychiatric nurse practitioner. Examinations may be done jointly, but each practitioner signs a separate certificate.

How recent must the OMH 471 examinations be?

The certifying examinations must be made within 10 days before the date of admission, and the application must also be made within that 10-day window. A staff psychiatrist at the admitting hospital then confirms the need for involuntary care before admission in Part B.

What is the OMH 471B used for?

It lets an examining physician or psychiatric nurse practitioner request, under section 9.27(i), that a peace or police officer or an ambulance service take the person into custody and transport them to the hospital, once both certificates and the application are complete.