Form 3 Agreement of participation
Baldwin's Kentucky Revised Statutes Annotated22nd Judicial Circuit - Fayette Mental Health Rules
KY FMHC Form 3
Form 3 Agreement of participation
MENTAL HEALTH COURT
CASE NO:
COMMONWEALTH OF KENTUCKY | PLAINTIFF |
VS. | AGREEMENT OF PARTICIPATION |
______________________________ | DEFENDANT |
* * * * * * * * *
I, __________, agree to the following terms and conditions as part of my participation in in Fayette Mental Health Court.
1.) I agree to participate in phase I, II, III and IV as they are written and attached hereto.
2.) I agree to take medication as prescribed.
3.) I agree to utilize the following services:
a.
b.
c.
d.
4.) I agree to the following special conditions:
a.
b.
c.
d.
5.) I agree to refrain from taking medications or narcotics that are not proscribed to me.
6.) I agree to refrain from self-harm or from harming others.
7.) I agree to work with Fayette Mental Health Court staff or their designees in order to aid in my recovery.
By the Defendant following the terms of mental health court and the specific conditions set forth in this agreement his charges will be __________.
SIGNED | |
Mental Health Court Coordinator | Defendant |
Judge | Defense Counsel |
Commonwealth |
Credits
HISTORY: Adopted effective July 7, 2014.
<Including Amendments Received Through January 1, 2022>
Fayette Mental Health Court Form 3, KY R FAYETTE MNTL HLTH CT Form 3
Current with amendments received through November 15, 2023. Some rules may be more current, see credits for details.
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