
Date
of Last Review 10/13/08
SME: Director of Social Services
UTHCPC staff members have responsibilities for certain steps in legal issues,
in support of Probate Court procedures.
UTHCPC uses 18 forms for the legal issues most often encountered at UTHCPC alone or in combination. These forms are based on Texas legal statutes and have been developed in conjunction with, and approved by the following:
![]() | Harris County Probate Court No. 3 |
![]() | The Harris County Attorney's office |
The 18 forms can be divided into three aspects of the treatment process:
![]() | Admission |
![]() | Treatment |
![]() | Discharge |
The following forms are used for admission:
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![]() | Certificate of Medical Exam with OPC Sec. 3.03 - Chemical Dependency |
![]() | Certificate of Medical Examination Modification to Inpatient Section 53 |
![]() | Certificate of Medical Examination with OPC - Temporary- Section 33 |
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Certificate of Return - Application and Affidavit to Magistrate |
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Certificate of Return - To Any Health or Peace Officer in the State of Texas |
![]() | Certificate of Least Restrictive Alternative (also used regarding treatment) |
![]() | Request for Temporary Detention for Modification - Section 53 |
The following forms are used regarding treatment:
![]() | Certificate of Medical Examination with OPC - Extended - Section 33 |
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The following forms are used regarding discharges:
![]() | Application for Modification - Inpatient to Outpatient or Change of Programs |
![]() | Certificate of Medical Examination - Modification to Outpatient - Section 53 |
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![]() | Termination of Court-Ordered Inpatient Mental Health Services |
JCAHO CC 6
JCAHO LD 1.3-1.3.2
JCAHO RI 1.2.2
Texas Mental Health Act

If you have questions regarding the contents of this site please contact the
Policies and Procedures Committee.
If you experience any technical problems please contact the MIS Department..