When an examiner at a Florida Baker Act receiving facility concludes that a person brought for involuntary examination does not meet criteria for involuntary inpatient placement or involuntary outpatient services, this form records that determination and approves release. The examiner checks reasons in both categories and describes the observations behind the decision.
A psychiatrist, clinical psychologist, emergency department physician or psychiatric nurse who examined the person completes and signs it, with license number and the date and time of the examination.
Download the current version from the source each time; forms change without notice.
Approval for Release of Individual on Involuntary Status from a Receiving Facility
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A psychiatrist, clinical psychologist, emergency department physician or psychiatric nurse who examined the person. The examiner signs with a license number and records the date and time the examination took place.
Yes. The examiner must check at least one reason why inpatient placement criteria are not met and at least one reason why involuntary outpatient criteria are not met, then describe the observations on which the determination was made.
Yes. The signature line lists psychiatrist, clinical psychologist, emergency department physician and psychiatric nurse as the professions that may approve release of a person on involuntary status from a receiving facility.