Iowa Rule 12.36 Form 9: Inpatient Periodic Report

While an Iowa respondent remains under an order for continued hospitalization, the chief medical officer reports periodically to the district court on this form under Iowa Code 229.15(1). It records whether the condition improved, stayed the same or deteriorated, current findings on mental illness and dangerousness, the respondent's placement, and a recommendation on further treatment.

Who completes it

The chief medical officer of the hospital completes and signs the report. The respondent does not complete any part.

Submitting and payment

How to submit it
File it with the district court in the respondent's case at the intervals the law requires; Iowa courts require electronic filing unless otherwise required or authorized.

Good to know

  • Item 10 reports placement: tentative discharge under 229.16, continued hospitalization, transfer, or leave under 229.15(5) with a return date.
  • If recommending continued inpatient care, estimate the further length of hospitalization or say it cannot be determined, and recommend staying, transfer or leave.
  • If you check 10(A) or 11(A), stop and sign. Otherwise explain why the recommended treatment is the least restrictive and effective option.
  • Sign with a digitized signature or by printing and signing by hand. April 2024 edition, five fillable pages; Form 10 covers outpatients.

Get the official form

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

Chief Medical Officer's Periodic Report (Respondent Inpatient)

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

What is the difference between Iowa Forms 9 and 10?

Form 9 is the chief medical officer's periodic report for a respondent hospitalized as an inpatient under Iowa Code 229.15(1). Form 10 is the periodic report for a respondent ordered into outpatient or other treatment under 229.15(2), which the treating psychiatrist or psychiatric ARNP may also sign.

Can a respondent be transferred or placed on leave?

Yes. Item 10 lets the chief medical officer report a transfer to another location or placement on leave under Iowa Code 229.15(5) when in the respondent's best interests, with the date and, for leave, the date the respondent was told to return.

What findings does Iowa Form 9 ask for?

Your opinion on whether the respondent is mentally ill, with diagnosis and supporting facts; can make responsible treatment decisions; is likely to injure self or others or cause serious emotional injury; cannot meet basic needs; and has a history of harmful noncompliance with treatment.