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Massachusetts MPC 402: Clinical Team Report

The Probate and Family Court requires the MPC 402 before it appoints a guardian or conservator for a person with an intellectual disability. A licensed psychologist, registered physician and licensed social worker examine the person and report together on diagnosis and IQ results, decision-making capacity, intrusive treatments including antipsychotic medication, risks, social supports and attendance at the hearing. It replaces the MPC 400 in these cases.

Who completes it

A licensed psychologist, registered physician and licensed social worker, each licensed in Massachusetts and experienced in evaluating people with intellectual disabilities, complete all eight sections, and each signs under the penalties of perjury.

Submitting and payment

How to submit it
The court's online e-form is the main version; an alternative savable PDF for Adobe Reader lets the team save a partly completed report. The petitioner files the finished report, printed on quality bond paper, with the guardianship petition.

Good to know

  • The examination must have taken place within 180 days of filing the petition, under G.L. c. 190B, section 5-306(b)(5).
  • No section may be left blank. Write Not Applicable where a question does not apply, and keep statements brief and relevant.
  • Each clinician answers the questions within their own knowledge, then the answers are merged into one report; original signatures may be on one page or in counterpart.
  • On antipsychotic medication, the only question is whether the person can give informed consent, not whether the medication is needed; a Rogers order may follow.

Get the official form

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

Clinical Team Report

Official pagePDFOnline formVersión en español

Get the note ready with Vero

This form is completed online with Massachusetts Probate and Family Court, so there is no PDF to fill. Vero Scribe writes the visit note it draws on, so the details are ready when you complete it.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who must sign the Massachusetts Clinical Team Report?

Three clinicians: a licensed psychologist, a registered physician and a licensed social worker, each experienced in evaluating people with intellectual disabilities. All signatures must be originals but need not be on the same page, and signature dates do not have to match the examination dates.

Is the MPC 402 available in Spanish?

Yes. The court posts a Spanish edition titled Informe del Equipo Clinico as a separate download next to the English report, along with the online e-form and the alternative savable PDF.

What instructions does the court give for the MPC 402?

The MPC 901 instructions ask clinicians to review psychological assessments and test reports before the exam, interview the care providers who know the person best, state IQ scores from test reports, and tell the person the evaluation may be used to remove decision-making rights. MPC 903a lists sample limitations for a limited guardianship.