Forms for Involuntary Commitment

Model Forms for Involuntary Commitment can be found below.

Please note: As a result of laws passed by the Tennessee General Assembly in the Spring of 2024, amendments to Title 33 take effect July 1, 2024. In response, the department has updated forms below and published a memo regarding the changes which can be accessed at this link.

MH-5542 (Printable) Fillable Version		CERTIFICATE OF NEED FOR EMERGENCY ADMISSION UNDER TITLE 33, CHAPTER 6, PART 4, TENNESSEE CODE ANNOTATED
MH-5098		FIRST OR FOLLOW UP NOTICE OF ADMISSION BY HOSPITAL OR TREATMENT RESOURCE UNDER TENN. CODE ANN. §33-6-413
MH-5099 (Printable) Fillable Version		EX PARTE ORDER TO HOLD DEFENDANT FOR EMERGENCY DIAGNOSIS, EVALUATION, AND TREATMENT UNDER TENN. CODE ANN. §33-6-413
MH-5100		ORDER APPOINTING COUNSEL UNDER TENN. CODE ANN. §33-3-608
MH-5450		NOTICE FROM GENERAL SESSIONS COURT PURSUANT TO T.C.A. §33-6-413(b)
MH-5101		CHIEF OFFICER'S NOTICE OF EMERGENCY ADMISSION AND HEARING UNDER TENN. CODE ANN. §33-6-416
MH-5102 (Printable) Fillable Version		ORDER TO RELEASE DEFENDANT UNDER TENN. CODE ANN. §33-6-413
MH-5103		NOTICE BY CHIEF OFFICER OF RELEASE BEFORE PROBABLE CAUSE HEARING UNDER TENN. CODE ANN. §33-6-417
MH-5104		ORDER UNDER TENN. CODE. ANN. §33-6-423 DISMISSING PROBABLE CAUSE PROCEEDINGS BASED ON DISCHARGE FROM EMERGENCY COMMITMENT
MH-5105		PETITION TO GENERAL SESSIONS COURT TO TRANSFER PROCEEDINGS UNDER TENN. CODE ANN. §33-6-417
MH-5106		ORDER UNDER TENN. CODE ANN. §33-6-417 TRANSFERRING PROBABLE CAUSE PROCEEDINGS
MH-5034 (Printable) Fillable Version		CERTIFICATE OF NEED REQUIRED UNDER. TENN. CODE ANN §33-6-421 FOR PROBABLE CAUSE HEARING
MH-5107		WAIVER OF PRESENCE AT PROBABLE CAUSE HEARING UNDER TENN. CODE ANN. §33-3-612(b)
MH-5108		WAIVER OF PROBABLE CAUSE HEARING UNDER TENN. CODE ANN. §33-6-420
MH-5109		CONSENT TO TESTIMONY BY AFFIDAVIT OR DEPOSITION UNDER TENN. CODE ANN. §33-3-615
MH-5110		ORDER RELEASING DEFENDANT FOLLOWING PROBABLE CAUSE HEARING UNDER TENN. CODE ANN. §33-6-423
MH-5111		ORDER FOLLOWING PROBABLE CAUSE HEARING DIRECTING THAT DEFENDANT BE HELD PENDING HEARING FOR INVOLUNTARY COMMITMENT UNDER TITLE 33, CHAPTER 6, PART 5, TENN. CODE ANN.
MH-5032 (Printable) Fillable Version		CERTIFICATE OF NEED FOR INVOLUNTARY COMMITMENT UNDER TITLE 33 CHAPTER 6, PART 5, TENNESSEE CODE ANNOTATED
MH-5112		COMPLAINT FOR INVOLUNTARY COMMITMENT UNDER TITLE 33, CHAPTER 6, PART 5, TENN. CODE ANN.
MH-5113		NOTICE OF HEARING ON COMPLAINT FOR INVOLUNTARY COMMITMENT UNDER TITLE 33, CHAPTER 6, PART 5, TENN. CODE ANN.
MH-5114		WAIVER OF PRESENCE AT INVOLUNTARY COMMITMENT HEARING UNDER TENN. CODE ANN. §33-3-612(b)
MH-5115		ORDER DIRECTING THAT DEFENDANT BE INVOLUNTARILY COMMITTED UNDER TITLE 33, CHAPTER 6, PART 5, TENN. CODE ANN.
MH-5116		ORDER DIRECTING THAT DEFENDANT BE TAKEN INTO CUSTODY FOR EXAMINATION UNDER TENN. CODE ANN. §33-3-607
MH-5117		ORDER DISMISSING COMPLAINT FOR INVOLUNTARY COMMITMENT UNDER TITLE 33, CHAPTER 6, PART 5, TENN. CODE ANN.