Form 5 Affidavit of violations of mental health court program
Baldwin's Kentucky Revised Statutes Annotated22nd Judicial Circuit - Fayette Mental Health Rules
KY FMHC Form 5
Form 5 Affidavit of violations of mental health court program
MENTAL HEALTH COURT
CASE NO:
COMMONWEALTH OF KENTUCKY | PLAINTIFF |
VS. | AFFIDAVIT OF VIOLATIONS OF MENTAL HEALTH COURT PROGRAM |
______________________________ | DEFENDANT |
* * * * * * * * *
Comes the affiant, __________ (mental health court coordinator), and after first being duly sworn, states that he is the Coordinator of the Fayette County Mental Health Court for the Commonwealth of Kentucky.
The affiant states that the defendant had the following violation(s):
___ Did not attend hearing
___ Did not attend treatment meetings
___ Did not comply with service plan
___
Failed drug screen on the dates of
__________
, testing positive for
___ Committed/Charged with __________ (offense) on __________ (date)
___ Other violation of agreed treatment plan, (please explain)
Signed __________. (Mental Health Court Coordinator)
Fayette County Mental Health Court
Subscribed and Sworn to before me by __________ on this the ___ day of __________, 20 ___.
Attested Copies to:
FAYETTE
__________
COURT, DIVISION
Defense Attorney County Attorney
Bluegrass.org Probation
Pretrial
Credits
HISTORY: Adopted effective July 7, 2014.
<Including Amendments Received Through January 1, 2022>
Fayette Mental Health Court Form 5, KY R FAYETTE MNTL HLTH CT Form 5
Current with amendments received through November 15, 2023. Some rules may be more current, see credits for details.
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