IN THE CIRCUIT COURT OF _________________ COUNTY, WEST VIRGINIA
IN RE: Involuntary Hospitalization of
Case No. ________- MH -________
ORDER / COMMISSIONER'S RECOMMENDATION
CONFIRMATION OF FINAL COMMITMENT HEARING
HELD IN ANOTHER COUNTY
[W.Va. Code: §27-5-4(n)(2)]
This matter came before this Court on the __________ day of ___________________________, 20________, before the
Honorable __________________________________________________________, Mental Hygiene Commissioner / Judge of the
Circuit Court of ________________________ County, West Virginia, upon the transcript of a final commitment hearing held
pursuant to the provisions of West Virginia Code: § 27-5-4(n)(1) in __________________________________ County, West
Virginia, and upon the Order certifying the transcript of said hearing duly entered by the Mental Hygiene Commissioner / Circuit
Court of said County, the contents of which transcript and Order are incorporated herein by reference.
After reviewing the evidence contained in the transcript, the Mental Hygiene Commissioner / Circuit Court is satisfied, and
hereby FINDS, that the evidence, under the burdens and standards set forth in West Virginia Code: § 27-5-4, clearly, cogently and
convincingly proves that the Respondent should be hospitalized.
Accordingly, it is hereby RECOMMENDED [by Commissioner] and ORDERED [by Judge]:
That the Respondent be committed, for the time period specified below, to the custody of the Secretary of the Department of
Health and Human Resources and be admitted to _________________________________________________________
mental health facility, or such other facility as determined appropriate by said Department.
That the commitment herein ordered shall be [initial one]
__________ for a temporary period of observation not to exceed six (6) months, or
__________ for an indeterminate period not to exceed two (2) years,
unless, previous to the expiration of this period, thi