Two sworn certificates of need must support a complaint for judicial, non-emergency involuntary commitment under Title 33, Chapter 6, Part 5. A clinician meets this one after personally examining the person named in the complaint. The examiner documents facts and reasoning for each of four criteria under Tenn. Code Ann. § 33-6-502, and the notarized certificates are filed with the complaint in probate or circuit court.
The examiner checks one box: licensed physician; psychologist with health service provider designation, when a licensed physician completed the other certificate; or qualified advanced practice provider under § 33-6-407(a) who is not in a collaborating agreement with the physician who signed the other one. A notary completes the sworn-to-and-subscribed block.
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Certificate of Need for Involuntary Commitment under Title 33, Chapter 6, Part 5, Tennessee Code Annotated
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A licensed physician, a psychologist with health service provider designation, or a qualified advanced practice provider as defined in § 33-6-407(a). Two certificates are needed: if one comes from an HSP psychologist, a licensed physician completes the other, and a qualified advanced practice provider may sign only when the other certificate's physician is not their collaborating physician.
The form states that the date of execution must be within three days of the examination. The examiner records the signature date, time and a phone number, and a notary completes the sworn-to-and-subscribed block. The two certificates then go to probate or circuit court with the complaint for involuntary commitment.
The department revised it for Title 33 amendments effective July 1, 2024. Public Chapter 785 lets a qualified advanced practice provider complete one of the two certificates, and Public Chapter 784, known as Jillian's Law, presumes that a person found incompetent to stand trial on a felony or Class A misdemeanor due to mental illness meets the commitment standard, unless rebutted.