New York Codes, Rules and Regulations › Title 22 - JUDICIARY › Subtitle D - Forms › Chapter II - Cpl Section 330.20 Forms › Forms (cf. Part 110) › Form B - Examination order (outpatient examination)

Current through Register Vol. 46, No. 28, July
				  10, 2024
FORM B
EXAMINATION ORDER
(OUTPATIENT EXAMINATION)
STATE OF NEW YORK
SUPREME COURT COUNTY COURT
PART: ________ COUNTY: ____________
________
PEOPLE OF THE STATE OF NEW YORK
Indictment No. ____________
vs. Crime Charged:
________
Defendant
________
Present:
Honorable ____________
Justice of the Supreme Court
Judge of the County Court
The above-named defendant having been found
					 not responsible by reason of mental disease or defect by verdict (C PL 300.10,
					 subd. 4[d])
by plea (C PL 220.15)
and such defendant not being in custody at
					 the time of such verdict or plea because he she was previously released on bail
					 on own recognizance,
NOW THEREFORE, it is
ORDERED that the said defendant submit to a
					 psychiatric examination to determine whether he she has a dangerous mental
					 disorder, as that term is defined in paragraph (c) of subdivision 1 of C PL
					 330.20, and if the said defendant does not have a dangerous mental disorder, to
					 determine whether he she is mentally ill, as that term is defined in paragraph
					 (d) of subdivision 1 of C PL 330.20, and it is further
ORDERED that the State Commissioner of
					 Mental Health shall designate two qualified psychiatrists to conduct the
					 aforesaid psychiatric examination, except that the Commissioner may, in his
					 discretion, designate one qualified psychiatrist and one licensed psychologist
					 to conduct the aforesaid examination, and such designated psychiatric
					 examiners, in conducting their examination, may employ any method which is
					 accepted by the medical profession or acceptable to licensed clinical
					 psychologists for the examination of persons alleged to be suffering from a
					 dangerous mental disorder or to be mentally ill or retarded, and it is
					 further
ORDERED that a psychiatrist or psychologist
					 retained by the above-named defendant may be present at the aforesaid
					 psychiatric examination, and it is further
ORDERED that such psychiatric examination be
					 conducted on an outpatient basis, and at such time and place as the State
					 Commissioner of Mental Health shall designate, and it is further
ORDERED that such psychiatric examination
					 shall be completed within 30 days after the defendant has first reported to the
					 place designated by the State Commissioner of Mental Health unless the court,
					 upon application of the said Commissioner, subsequently extends such period in
					 the manner prescribed by law, and it is further
ORDERED that each psychiatric examiner
					 designated by the State Commissioner of Mental Health to conduct the aforesaid
					 psychiatric examination shall, upon completion of the examination, promptly
					 prepare a report of his or her findings and evaluation concerning the
					 defendant's mental condition and submit such report to the said Commissioner,
					 and upon receipt and review of such report from each designated psychiatric
					 examiner, the said Commissioner shall submit four copies of each such report to
					 the court that issued this examination order.
Dated: ________
____________
Justice of the Supreme Court
Judge of the County Court
Name, Address and Telephone Number of Court
					 Clerk:
________
________
________
________
Name, Address and Telephone Number of
					 District Attorney:
________
________
________
________
Name, Address and Telephone Number of
					 Counsel for Above-named Defendant:
________
________
________
________
Name, Address and Telephone Number of
					 Above-named Defendant:
________
________
________
________
Note: The Clerk of the Court must promptly
					 forward or furnish a copy of this Examination Order to each of the following
					 persons:
1. State
				  Commissioner of Mental Health.
[contact Director of Forensic Services,
					 telephone 518: 474-7275]
2. Director of Mental Health
				  Information Service.
3. Defendant.
4. Counsel for
				  Defendant.
5.
				  District Attorney.
Notice to the above-named Defendant:
This Examination Order requires you to
					 submit to a psychiatric examination on an outpatient basis.
You will be notified of the place where such
					 examination will be conducted.
When you are so notified, you must appear at
					 such place on the date and at the time specified in such notice.
Failure to comply with this Examination
					 Order constitutes a contempt of court which may result in the imposition of
					 penal sanctions.