Request for Release from Voluntary Admission

Use of form

Date of Last Review 10/13/08
SME: Director of Social Services

The Request for Release from Voluntary Admission is the form used to discharge a voluntary patient at his/her request or the request of his/her parent, guardian, or conservator.

Summary

All patients voluntarily admitted for treatment have the right to be discharged within four hours of their request unless the attending physician in charge has reason to believe that the patient may meet criteria for court-ordered mental health services or emergency detention.

Minors under 16

For voluntary patients under 16 years of age, a parent, guardian, or conservator can make the request for discharge.

Patient request

This table describes how the nursing staff handles the patient's request for release:

Stage	Description
1	The patient notifies a staff member of his/her desire for discharge.
2	Staff then prepares a Request for Release form including the date and time of the request.
3	Does the patient want to sign the form? If yes, staff obtains his/her signature and process continues to stage 5. If no, staff handles the patient's verbal request as though it was written and notes on the form that the patient requested discharge but refused to sign. Document the witness signature on the form. The process continues to stage 5.
4	Staff distributes the completed Request for Release form as follows: Original to the patient's chart Yellow copy to the patient
5	Staff notifies the appropriate physician of the request as soon as it is received.

Within four hours of request

This table describes what staff does within four hours of the patient's request for release:

Stage	Person Responsible	Description
1	The physician	Evaluates the patient Makes a preliminary decision as to whether the criteria for involuntary hospitalization appear to be met If discharging the patient is against medical advice, see Statement of Patient Leaving Against Medical Advice Informs the patient of his/her decision
2	The physician	Does s/he decide to seek court ordered services? If yes, does not order discharge but completes a Certificate of Medical Examination (or initiates an emergency detention order) within 24 hours of the original request for release and the process continues to stage 3 If no, approves and writes an order for discharge as a voluntary refusal of treatment or against medical advice and the process continues to stage 4
3	The physician	Obtains a court-order by 4:00 p.m. of the next court workday after the examination
4	Unit staff	Notifies the patient's family or significant other, if applicable, of the patient's request and the physician's decision
5	Social Services clinician	If a patient is being discharged, implements the aftercare plan as soon as possible Sufficient time: If sufficient time to prepare the aftercare plan is not available before discharge: Sends the plan to the aftercare provider within 24 hours Notifies the patient of the plan

Related standards

Related to regulatory standards

If you have questions regarding the content of this site please contact the Policy and Procedure Committee. If you experience any technical problems please contact the MIS Department.