Form 48212 - Order Continuing Regular Commitment Without Hearing Form
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1STATE OF INDIANA
IN THE
COURT
COUNTY OF
CAUSE NO.
_
In the matter of the Commitment of
_
ORDER CONTINUING REGULAR COMMITMENT WITHOUT HEARING
A Periodic Report on Regularly Committed patient was filed by
on _______________________20____.
The court having studied said Report, now approves it and adopts its recommendations.
is accordingly recommitted to
Richmond State Hospital
for continued custody, care or treatment until the
patient has been discharged or until the court terminates the commitment.
The patient and his/her representatives are hereby notified that a hearing for review or
dismissal of the commitment may be requested.
The superintendent, his designee or the attending physician is directed to submit the next
Periodic Report on said patient no later than ____________________, 20____.
The clerk is directed to mail a copy of this order to the patient, the person who signed the
Periodic Report, and the following additional persons:
___________________________________________________________________________
___________________________________________________________________________
SO ORDERED this ______________day of____________________________20___.
_______________________________________
Judge, ___________________________Court
State Form 48212 (1-01)
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