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PDF PCM 215a, Certification and Report on Petition for - Michigan Courts

PDF PCM 215a, Certification and Report on Petition for - Michigan Courts 2025

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The document is a certification and report form used by the Probate Court in Michigan for evaluating individuals petitioning for judicial admission due to potential mental health issues. It includes sections for examiners to assess whether the individual meets treatment criteria, has an intellectual disability, poses a risk of harm to themselves or others, and requires immediate admission to a facility. Additionally, it outlines alternative care options and recommendations for appropriate living arrangements.

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Click ‘Get Form’ to open the PDF PCM 215a in our editor.
Begin by entering the 'File No.' at the top of the form. This is essential for tracking your petition.
In the section labeled 'Certification of Examiners', fill in the individual's full name and date of examination. Indicate whether they meet treatment criteria and provide a diagnosis.
For questions regarding potential harm, select 'can' or 'cannot' based on your assessment. Provide supporting facts in the designated area.
Complete the second examiner's section similarly, ensuring all fields are filled accurately.
In the 'Report on Petition for Judicial Admission', enter your name, profession, and details about the individual's condition. List available care options and make recommendations as needed.
Finally, sign and date the form at the bottom to certify its accuracy before submission.

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