Declaration of Mental Health Care Treatment - Indiana 2026

1. Click ‘Get Form’ to open the Declaration of Mental Health Care Treatment in the editor.
2. Begin by filling in your name at the top of the form, ensuring you are an adult of sound mind.
3. In the section regarding psychotropic medications, indicate your consent preferences by checking the appropriate boxes and listing any specific medications.
4. Next, address electroconvulsive treatment by selecting your consent status and noting any conditions or limitations.
5. For admission to a health care facility, specify your wishes similarly, ensuring clarity on consent or refusal.
6. If desired, select a physician for determining incapacity. Fill in their name and contact information.
7. Finally, sign and date the document at the bottom. Ensure witnesses complete their affirmation as required.

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