1964_MENTAL_HEALTH_REGULATIONS — Page 36

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CAP. 136]

Mental Health Regulations

[1989 Ed.

[Subsidiary]

FORM 12

MENTAL HEALTH ORDINANCE

(Chapter 136)

(Section 42B(3))

Notice of recall of a conditionally discharged patient

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

In pursuance of section 42B(3) of the Mental Health Ordinance I,

*Medical Superintendent of

Hospital/medical officer authorized by the Director of Hospital Services, *recall/call you to

Hospital *forthwith/within

days of the date of service of this notice (See Note 1). (a) It appears to me that you have failed to comply with the following conditions to which

your discharge on [date]

was subject--

[list breaches of condition]

AND

(b) I am of the opinion that your *recall/call to a mental hospital is necessary (See Note 2)-

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

(ii) for the protection of other persons.

Please note that if you do not attend at

Hospital as required by this notice,

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

and taken into custody and removed to

Hospital by any officer or servant of the Hospital or any person authorized by me.

Signed

Medical Superintendent/Medical Officer

Date

* Delete as appropriate.

Notes: 1.

2.

3.

A patient recalled/called to a mental hospital in pursuance of section 42B(3) of the Mental Health Ordinance shall upon admission to a mental hospital be deemed to have been detained under section 31 of the Mental Health Ordinance. Delete (i) or (ii) unless both apply.

Delete words in square brackets if the patient prior to conditional discharge was detained under a hospital order other than one endorsed under section 45(1A) of the Mental Health Ordinance.