Civil Commitment and Judicial Medical Consent
All forms are in Adobe format unless otherwise specified.

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2011 Richmond Mental Health Judge Schedule

Psychiatric Hospital and Crisis Intervention Telephone and Facsimile Numbers

Chief Magistrates throughout the Commonwealth


Virginia Statutes Applicable to Civil Commitment


Virginia Statutes Applicable to Judicial Authorization of Treatment


 MEDICAL EMERGENCY CUSTODY PETITION (to transport incapacitated patient from community by ambulance)  Only the magistrate may issue an order to transport the patient from the community to a hospital. In Richmond, the Chief Magistrate is presently Ms. Deborah Meade-Jackson.  The contact information for her office is:

Hon. Deborah Meade-Jackson
Chief Magistrate, Thirteenth Judicial District
200 West Grace Street, First Floor
Richmond, Virginia  23220
804/646-6691 or 804/646-6689



Virginia Civil  Commitment & Medical Consent Forms For Doctors, Hospitals and Lawyers  (INCLUDING EMERGENCY FORMS)

bullet External Site Preadmission Screening Report, Examination and Voluntary Admission Forms

The Department of Behavioral Health and Developmental Services is responsible for preparing the preadmission screening report, examination and voluntary admission forms. According to the Department, "[m]inor revisions to these forms incorporate 2009 legislation effective 7/1/09."

  1. Uniform Preadmission Screening and Report form
  2. Preadmission Screening CCS3 Values Sheet
  3. 1001 — Application for Voluntary Admission
  4. 1001-B — Application for Voluntary Admission Pursuant to Section 37.2-814
  5. 1002-IE — Independent Examination, Certification and Recommendations for Placement, Care and Treatment
  6. 1002-IE — Independent Examination, Certification and Recommendations for Placement, Care and Treatment—Print Only
  7. Advance Medical Directive Form Sample advance medical directive form from the 2009 Health Care Decision Act


External Site Court Forms

Effective July 1, 2009, the Office of the Executive Secretary of the Supreme Court assumed responsibility for preparing and distributing the petitions, orders and such other legal forms required for custody, detention, and involuntary admission. Some of these forms are online, and some are only available from the clerks of courts.


Attorney's Statement to Patient (7/11) (For City of Richmond)


Richmond Behavioral Health Authority Web Site


Richmond Hospitals: Judge Cosby Cases