1964_MENTAL_HEALTH_REGULATIONS — Page 28

A 28

CAP. 136]

Mental Health Regulations

[1989 Ed.

[Subsidiary]

FORM 8

MENTAL HEALTH ORDINANCE

(Chapter 136)

(Section 39(3))

Notice of revocation of permission to be absent on trial

To: [name of patient, and, if known, identity card number and address] .

In pursuance of section 39(3) of the Mental Health Ordinance I,

Medical Superintendent of

Hospital, give you notice that permission for you to be absent on trial from [date]

is hereby revoked and you are required to return to

(See Note 1).

I am of the opinion that your recall is necessary (See Note 2)-—

(a) in the interests of your own health or safety; and

(b) for the protection of other persons.

Please note that if you do not return to

Hospital forthwith

Hospital forthwith,

then (See Note 3) [for a period of 28 days from the date of the service of this notice] you may be

taken into custody and returned to

the Hospital or any person authorized by me.

...... Hospital by any officer or servant of

Signed

Medical Superintendent

Date

་་་་་----

A patient may not be recalled in pursuance of section 39(3) of the Mental Health Ordinance after he or she has ceased to be liable to be detained under the Ordinance.

Notes:

1.

2.

Delete (a) or (b) unless both apply.

3.

Delete words in square brackets if the patient is liable to detention under a hospital order other than one endorsed under section 45(1A) of the Mental Health Ordinance.