The Director of Mental Health requires the use of the Mental Health Act forms identified below, under Section 133A of the Mental Health (Compulsory Assessment and Treatment) Act 1992 (the Mental Health Act).
Forms
Word format
These forms can be filled out electronically.
- Leave of absence for patient subject to s11 or s13 (Word, 49 KB)
- Transport plan template 28 October 2022 (Word, 387 KB)
- Section 8A. Application for assessment 16.11.2021 (Word, 53 KB)
- Section 8B. Certificate supporting an application for assessment (Word, 61 KB) – Updated 31 January 2024
- Notice to attend an assessment examination. Section 9 (Word, 52 KB) – Updated 1 November 2021
- Certificate of preliminary assessment. Section 10 (Word, 62 KB) – Updated 1 November 2021
- Clinical Report for Director of Area Mental Health Services (Word, 64 KB) - Updated 1 November 2021
- Notice requiring patient to undergo a 5 day further period of assessment and treatment. Section 11 (Word, 49 KB) – Updated 1 November 2021
- Notice to patient subject to a community treatment order directing change to inpatient status under section 29(3)(a) or re-assessment under section 29(3)(b) (Word, 53 KB)
- Section 29 Order (Word, 261 KB)
- Section 29 Extension Order 6 months (Word, 263 KB)
- Section 29 Extension Order 12 months (Word, 261 KB)
- Section 30 Order (Word, 261 KB)
- Section 30 Extension Order 6 months (Word, 261 KB)
- Section 30 Extension Order 12 months (Word, 262 KB)
- Section 34. Application for extension of compulsory treatment order (Word, 255 KB) – Updated 27 October 2023, effective 29 October 2023
- Section 34. Application for extension of compulsory treatment order – Printable version (Word, 246 KB) – Updated 24 October 2023, effective 29 October 2023
- Application for assessment of person detained in a penal institution. Section 45 (Word, 52 KB) – Updated 1 November 2021
- Transfer of detained person. Section 46 (Word, 63 KB)
- Section 79(7) Certificate of Tribunal Review 22.11.2021 (Word, 59 KB) – Updated 29 November 2021
- Reportable event notification form (Word, 113 KB) – Updated 17 May 2023
- Section 113A: Warrant to enter premises where person or proposed patient or patient is (Word, 34 KB)
- Section 113A: Warrant to apprehend proposed patient or patient (Word, 36 KB)
PDF format
These forms can be printed and filled out manually.
- Leave of absence for patient subject to s11 or s13 (PDF, 167 KB)
- Transport plan template 28 October 20222 (PDF, 231 KB)
- Section 8A Application for assessment 16.11.2021 (PDF, 195 KB)
- Section 8B. Certificate supporting an application for assessment (PDF, 178 KB) – Updated 15 March 2024
- Notice to attend an assessment examination. Section 9 (PDF, 201 KB) – Updated 1 November 2021
- Certificate of preliminary assessment. Section 10 (PDF, 193 KB) – Updated 1 November 2021
- Clinical Report for Director of Area Mental Health Services (PDF, 225 KB) – Updated 1 November 2021
- Notice requiring patient to undergo a 5 day further period of assessment and treatment. Section 11 (PDF, 142 KB) – Updated 1 November 2021
- Leave of absence for a patient subject to a section 11 or section 13 assessment notice Section 11(5)(b) or 13(5)(b) (PDF, 123 KB)
- Notice to patient subject to a section 11 or section 13 assessment notice directing change from outpatient to inpatient status. Section 11(3), 13(3) (PDF, 32 KB)
- Notice to patient subject to a section 11 or section 13 assessment notice directing change from inpatient to outpatient status. Section 11(4), 13(4) (PDF, 32 KB)
- Certificate of further assessment. Section 12 (PDF, 153 KB)
- Notice requiring patient to undergo a 14 day further period of assessment and treatment. Section 13 (PDF, 33 KB)
- Certificate of final assessment. Section 14 (PDF, 302 KB)
- Application for compulsory treatment order. Section 14(4) (PDF, 22KB)
- Report form for Second Health Professional. Section 16(4) (PDF, 119 KB)
- Notice to patient subject to a community treatment order directing change to inpatient status under section 29(3)(a) or re-assessment under section 29(3)(b) (PDF, 650 KB)
- Leave of absence for inpatient. Section 31 (PDF, 31 KB)
- Notice of cancellation of leave. Section 31(4) (PDF, 29 KB)
- Section 34. Application for extension of compulsory treatment order (PDF, 223 KB)
- Application for assessment of person detained in a penal institution. Section 45 (PDF, 170 KB) – Updated 1 November 2021
- Transfer of detained person. Section 46 (PDF, 197 KB)
- Application for leave to Director of Mental Health, Ministry of Health. Section 52 (PDF, 132 KB)
- Referral for second opinion under section 59(2)(b) (PDF, 18 KB)
- Section 59(2)(b) second opinion. Section 59 (PDF, 16 KB)
- Certificate of clinical review of condition of patient subject to compulsory treatment order. Section 76(3) (PDF, 82 KB)
- Certificate of clinical review of condition of patient found to be unfit to stand trial and detained as special patient. Section 77(3) (PDF, 82 KB)
- Certificate of clinical review of condition of special patient acquitted on account of insanity and detained as special patient. 77(4) (PDF, 82 KB)
- Certificate of clinical review of condition of restricted patient. Section 78(3) (PDF, 90 KB)
- Section 79(7) Certificate of Tribunal Review 22.11.2021 (PDF, 195 KB) – Updated 29 November 2021
- Certificate of Tribunal Review of condition of special patient found to be unfit to stand trial and detained pursuant to order made under Section 24(2)(A) of the Criminal Procedure (Mentally Impaired Persons) Act 2003 (PDF, 97 KB)
- Certificate of Tribunal Review of condition of special patient acquitted on account of insanity and detained pursuant to order made under Section 24(2)(A), Criminal Procedure (Mentally Impaired Persons) Act 2003 (PDF, 96 KB)
- Section 113A: Warrant to enter premises where person or proposed patient or patient is (PDF, 159 KB)
- Section 113A: Warrant to apprehend proposed patient or patient (PDF, 166 KB)
Patient’s consent form under S34D of the Mental Health Act
This consent form is available on the Ministry of Justice website.