When a person already in 14-day intensive treatment in California presents an imminent threat of taking their own life, the treating facility uses this notice to certify them for up to 14 more days under Welfare and Institutions Code section 5260 and following. It states the facts behind the allegation, names who signed the supporting affidavits, and lists services the person would not accept.
Two signers representing the intensive treatment facility, typically the professional person in charge and the treating physician or psychologist, complete and sign the notice. The affidavits it relies on accompany it.
Download the current version from the source each time; forms change without notice.
Notice of Certification for Additional 14 Days Intensive Treatment Pursuant to Section 5260, et seq. of the Welfare and Institutions Code
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DHCS 1808 certifies the first 14 days of intensive treatment, or 30 additional days for grave disability. DHCS 1809 is the follow-on certification for up to 14 more days when the person presents an imminent threat of taking their own life.
Supporting affidavits. The form states that the allegation of imminent suicide risk is supported by accompanying affidavits and asks for the names of those who signed them, along with the specific facts the allegation is based on.
A copy of the notice is personally delivered to the person, who must be clearly advised of the continuing right to judicial review by habeas corpus, with that term explained. Copies also go to the person's attorney, the public defender and the district attorney.