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.
- Clinical Report for Director of Area Mental Health Services. Section 10(2)* (Word, 73 KB)
- Application for assessment. Section 8A* (Word, 54 KB)
- Certificate supporting an application for assessment. Section 8B* (Word, 56 KB)
- Notice to attend an assessment examination. Section 9* (Word, 60 KB)
- Certificate of preliminary assessment. Section 10* (Word, 59 KB)
- Notice requiring patient to undergo a 5 day further period of assessment and treatment. Section 11* (Word, 49 KB)
- Application for assessment of person detained in a penal institution. Section 45* (Word, 52 KB)
- Transfer of detained person. Section 46 (Word, 63 KB)
- Certificate of Tribunal review of condition of patient subject to compulsory treatment. Section 79(7) (Word, 56 KB)
PDF format
These forms can be printed and filled out manually.
- Application for assessment. Section 8A* (PDF, 152 KB)
- Certificate supporting an application for assessment. Section 8B * (PDF, 127 KB)
- Notice to attend an assessment examination. Section 9* (PDF, 107 KB)
- Certificate of preliminary assessment. Section 10* (PDF, 152 KB)
- Clinical Report for Director of Area Mental Health Services. Section 10(2)* (PDF, 128 KB)
- Notice requiring patient to undergo a 5 day further period of assessment and treatment. Section 11* (PDF, 29 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, 70 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, 22 KB)
- Leave of absence for inpatient. Section 31 (PDF, 31 KB)
- Notice of cancellation of leave. Section 31(4) (PDF, 29 KB)
- Application for extension of compulsory treatment order. Section 34 (PDF, 34 KB)
- Application for assessment of person detained in a penal institution. Section 45* (PDF, 189 KB)
- 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)
- Certificate of Tribunal review of condition of patient subject to compulsory treatment. Section 79(7) (PDF, 112 KB)
- 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)
* Note: The COVID-19 Response (Further Management Measures) Legislation Act 2020 amended the content of these forms.