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[接上页] ....................................................................................................................................... ........................................................................................................................................ ................................................................ should be received into guardianship in pursuance of an application made under section 33(1) of the Mental Health Ordinance. I, [name of first practitioner]...................................................................................... ................................................................................................................... last examined the patient on ................................................................... In my opinion this patient is suffering from mental disorder of a nature or degree which warrants reception into guardianship under the Mental Health Ordinance. This opinion is founded on the following- [Give clinical description of the patient's mental condition] I am of the opinion that it is necessary (See Note 2)- (a) in the interests of the welfare of the patient; and (b) for the protection of other persons, that the patient should be so received for the following reasons- [Reasons should state why the patient cannot appropriately be cared for without powers of guardianship] Signed ....................................................Registered Medical Practitioner Date ........................................................ I, [name of second practitioner] ............................................................................... ......................................................................................................., last examined the patient on ...................................................................... In my opinion this patient is suffering from mental disorder of a nature or degree which warrants reception into guardianship under the Mental Health Ordinance. This opinion is founded on the following- [Give clinical description of the patient's mental condition] I am of the opinion that it is necessary (See Note 2)- (a) in the interests of the welfare of the patient; and (b) for the protection of other persons, that the patient should be so received for the following reasons- [Reasons should state why the patient cannot appropriately be cared for without powers of guardianship] Signed .....................................................Registered Medical Practitioner Date ........................................................ * Delete as appropriate. Notes: 1. At least one of the registered medical practitioners who signs this certificate must be approved for the purpose of section 2(2) of the Mental Health Ordinance by the Hospital Authority within the meaning of the Hospital Authority Ordinance (Cap 113). 2. Delete (a) or (b) unless both apply. (68 of 1990 s. 24) FORM 7 MENTAL HEALTH ORDINANCE (Chapter 136) (Section 36) CERTIFICATE OF MEDICAL PRACTITIONERS AS TO MENTAL DISORDER To: *The Medical Superintendent, ................................ Hospital. (See Note 1) *The Commissioner of Correctional Services (See Note 1) We, [names and addresses of two medical practitioners] ............................................ ........................................................................................................................................ ........................................................................................................................................ ..................................................................................., registered medical practitioners, *one/both of whom *has/have been approved for the purpose of section 2(2) of the Mental Health Ordinance by the Hospital Authority within the meaning of the Hospital Authority Ordinance (Cap. 113) (See Note 2), have *separately/together examined [name of patient, and, if known, identity card number] ..................................................... who is- *(a) a patient liable to be detained in a mental hospital or in the Correctional Services Department Psychiatric Centre; or *(b) a voluntary patient in a mental hospital who on [date on which notice was given under section 30(2)(a) of the Mental Health Ordinance] .................................... gave due notice of his intention to leave the hospital. In pursuance of section 36(1) of the Mental Health Ordinance we hereby certify as follows- I, [name of first practitioner] ..................................................................................., last examined the patient on ............................................... In my opinion this patient is suffering from mental disorder of a nature or degree which makes it appropriate for *him/her to receive medical treatment in hospital. This opinion is founded on the following- [Give clinical description of the patient's mental condition] |