New York OMH 474: Emergency Admission (MHL 9.39)

New York hospitals approved by the Commissioner of Mental Health record emergency involuntary admissions under Mental Hygiene Law section 9.39 on OMH 474. A clinician meets it when a person is brought to the hospital with a mental illness likely to result in serious harm. A staff physician documents the admission, and a staff psychiatrist must confirm the findings for the patient to be held beyond 48 hours.

Who completes it

A staff physician of the admitting hospital completes Section II, the record of admission. A second physician on the hospital's psychiatric staff completes Section III, the examination confirming need for admission beyond 48 hours, including history, physical condition, mental status and differential diagnosis.

Submitting and payment

How to submit it
The form stays with the admitting hospital, which gives the patient written notice of status and rights and sends notice to the Mental Hygiene Legal Service and up to three people the patient designates.

Good to know

  • Telehealth, by audio-visual means only, may be used for just one of the two examinations; the person is asked to consent and any refusal is documented.
  • Serious harm covers threats or attempts at suicide or self-harm, violent behavior placing others in fear, or inability to meet essential needs such as food, shelter or medical care.
  • Within 15 days the patient is discharged, stays voluntarily, or is retained only through a 9.27 application with two medical examinations (OMH 471).
  • The form may be completed and signed electronically, including in the EHR; the current edition is OMH Form 474 (3/2026).

Get the official form

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

Emergency Admission (Mental Hygiene Law §9.39)

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 signs the confirmation on the OMH 474?

A physician on the hospital's psychiatric staff who is not the admitting physician. Section III asks for history, physical condition including test results, psychiatric signs and symptoms, a mental status exam, collateral information and a differential diagnosis, then the staff psychiatrist's signed confirmation.

Can the OMH 474 exams be done by telehealth?

Only one of the two. Either the initial examining physician or the confirming psychiatrist may use audio-visual telehealth. The person must be asked to consent, and if they refuse or cannot consent, the effort is documented in the record and the examination may proceed.

How long can a patient be held on an OMH 474?

Up to 48 hours on the admitting physician's findings, then longer only after a staff psychiatrist confirms them. Within 15 days the patient must be discharged, agree to stay voluntarily, or be retained through the section 9.27 process with two medical examinations.