CAP. 136
Mental Health Regulations
[1989 Ed.
[Subsidiary]
FORM 2
MENTAL HEALTH ORDINANCE
(Chapter 136)
(Section 31(1A))
Certificate of a medical practitioner in support of application for removal of a patient to a mental hospital for the purpose of detention and observation
I, [name and address of medical practitioner]
a registered medical practitioner, am of the opinion that [name of patient, and, if known, identity card number and address]
should be removed to Hospital for the purpose of detention and observation in pursuance of an order made under section 31(1B) of the Mental Health Ordinance, I last examined this patient on [date]
I am of the opinion that this patient-
(See Note 1).
(a) is suffering from mental disorder of a nature or degree which warrants *his/her detention in a mental hospital for *observation/observation followed by treatment for at least a limited period;
AND
(b) ought to be so detained (See Note 2)-
(i) in the interests of *his/her own health or safety; and (ii) with a view to the protection of other persons.
The grounds for the opinion I express in paragraph (a) above are as follows-
The reasons for the opinion I express in paragraph (b) above are as follows-
The patient *has/has not requested to see the District Judge or Magistrate.
Signed
Registered Medical Practitioner
Date
* Delete as appropriate.
Notes: 1. The medical practitioner who gives this certificate must have examined the patient within the previous 7 days.
2. Delete (i) or (ii) unless both apply.