Mental Health Act forms
These forms can be used by clinicians and members of the public for mental health orders and information included in the Mental Health Act 2015 (the Act).
You can also refer to definitions of terms used in the the Act.
| Chapter | Section | Section name | Name of form | Form no. |
|---|---|---|---|---|
| 3 | 19 | Nominated person | Nominated Person - Appointment | 15156 |
| 3 | 26 | Entering into Advance Agreement | Advance Agreement | 15299 |
| 3 | 27 | Making Advance Consent Direction | Advance consent direction | 15303 |
| 3 | 30 | Effect of advance agreement and advance consent direction on guardian with authority to give consent for treatment, care or support | Consent to Mental Health Treatment, Care or Support by the Guardian | 15211 |
| 4 | 33 | Applications by people with mental disorder or mental illness-assessment order | ACAT Assessment Order Application Form | AF2016-30 |
| 4 | 34 | Applications by other people-assessment order | ACAT Assessment Order Application Form | AF2016-30 |
| 4 | 35 | Applications by referring officers-assessment order | ACAT Assessment Order Application Form | AF2016-30 |
| 5 | 51 | Application for mental health orders | Application form for psychiatric treatment order, community care order or restriction Order | AF2016-28 |
| 5 | 62 | Role of chief psychiatrist-PTO | PTO treatment plan and location determination | 10348 |
| 5 | 64 | Action if psychiatric treatment order no longer appropriate-no longer person in relation to whom ACAT could make order | Notice of revocation for PTO or RO | 15161 |
| 5 | 64(1)(b)(i) | Action if Psychiatric Treatment Order no longer appropriate: | Written notice to the carer and/or nominated person | 15140 |
5 | 64(1)(b)(i) | Action if a Restriction Order in conjunction with a Psychiatric Treatment Order is no longer appropriate | Written notice to the carer and/or nominated person | 151405 |
| 5 | 65 | Powers in relation to a PTO | Seclusion | 50010 |
| 5 | 65 | Powers in relation to a PTO | Seclusion and confinement observations | 604215 |
| 5 | 70(2) | Role of community care coordinator | Community forensic community care order-care plan-care coordinator's determination | 65463 |
| 5 | 70(3) | Role of community care coordinator | Application for leave from a facility | 15179 |
| 5 | 72(1)(b)(i) | Action if Community Care Order no longer appropriate | Written notice to the carer and/or Nominated person | 15140 |
| 5 | 72(1)(b)(i) | Action if a Restriction Order in conjunction with a Community Care Order is no longer appropriate | Written notice to the carer and/or Nominated person | 15140 |
| 5 | 72(4) | Action if CCO no longer appropriate | Application for revocation | 15162 |
| 5 | 72(4) | Action if CCO no longer appropriate | Notice of intent to revoke FTPO, CCO or FCCO | 15160 |
| 5 | 73(5) | Powers in relation to CCO | Seclusion | 50010 |
| 5 | 73(5) | Powers in relation to CCO | Seclusion or confinement observations | 60421 |
| 5 | 73(5) | Powers in relation to CCO | Mechanical physical restraint or forcible giving of medicine form | 35249 |
| 5 | 77(2)b | Contravention of mental health order | Contravention of mental health order - written warning | 15172 |
| 5 | 77(2)c | Contravention of mental health order | Notification of contravention and authorisation to require a person to be detained | 15165 |
| 5 | 78(4) | Contravention of mental health order-absconding from facility | Unauthorised leave from an inpatient facility-risk assessment | 35257 |
| 5 | 78(4) | Contravention of mental health order-absconding from facility | Notification of return from unauthorised leave | 10256 |
| 6 | 83 | Statement of action taken | Statement of action taken- apprehension by an authorised ambulance or police officer | 20264 |
| 6 | 83 | Statement of action taken | Statement of action taken- apprehension by a doctor or mental health officer | 20263 |
| 6 | 84 | Initial examination at approved mental health facility | Failure to conduct initial examination | 15155 |
| 6 | 85 | Authorisation of involuntary detention | Authorisation or notification of involuntary detention | 20250 |
| 6 | 85(2) | Authorisation of involuntary detention | Application for a Further Period of Involuntary Detention - not exceeding 11 days | 15151 |
| 6 | 88 | Treatment during detention | Seclusion | 50010 |
| 6 | 88 | Treatment during detention | Seclusion or confinement observations | 60421 |
| 6 | 88 | Treatment during detention | Mechanical physical restraint or forcible giving of medicine form | 35249 |
| 6 | 91 | Order for release | Release from Involuntary Detention | 15166 |
| 7 | 94 | Applications for forensic mental health orders - detainees | ACAT Application for a Forensic Mental Health Order | AF2016-32 |
| 7 | 103 | Role of chief psychiatrist-forensic psychiatric treatment order | FPTO Treatment Plan and Location Determination | 65464 |
| 7 | 103(2)a | Role of chief psychiatrist-forensic psychiatric treatment order | Leave whilst in detention-Forensic Mental Health orders | 15177 |
| 7 | 105(4) | Action if forensic psychiatric treatment order no longer appropriate-no longer person to whom ACAT can make order | Application for Revocation | 15162 |
| 7 | 105(1)(b) | Action if Forensic Psychiatric Treatment Order no longer appropriate | Written notice to the carer and/or Nominated person | 15140 |
| 7 | 106(4) | Action if Forensic Psychiatric Treatment Order no longer appropriate to detain person | Written notice to the carer and/or Nominated person | 15140 |
| 7 | 107 | Powers in relation to a FPTO | Seclusion | 50010 |
| 7 | 107 | Powers in relation to a FPTO | Seclusion/confinement observations | 60421 |
| 7 | 107 | Powers in relation to a FPTO |
| 35249 |
| 7 | 107(2)d | Powers in relation to a FPTO | Leave whilst in detention-Forensic Mental Health orders | 15177 |
| 7 | 110(2) | Role of care coordinator-forensic community care order | Community/Forensic Community Care Order-Care Plan-Care Coordinator's Determination | 65463 |
| 7 | 112(4) | Action if forensic community care order no longer appropriate- no longer person to whom ACAT could make order | Application for Revocation | 15162 |
| 7 | 105(1)(b) | Action if Forensic Psychiatric Treatment Order no longer appropriate | Written notice to the carer and/or Nominated person | 15140 |
| 7 | 106(1)(b) | Action if Forensic Psychiatric Treatment Order no longer appropriate to detain person | Written notice to the carer and/or Nominated person | 15140 |
| 7 | 107 | Powers in relation to a FPTO | Seclusion | 50010 |
| 7 | 107 | Powers in relation to a FPTO | Seclusion/confinement observations | 60421 |
| 7 | 107 | Powers in relation to a FPTO | Mechanical, Physical Restraint, or Forcible Giving of Medication Form | 35249 |
| 7 | 107(2)d | Powers in relation to a FPTO | Leave whilst in detention-Forensic Mental Health orders | 15177 |
| 7 | 110(2) | Role of care coordinator-forensic community care order | Community/Forensic Community Care Order-Care Plan-Care Coordinator's Determination | 65463 |
| 7 | 112(4) | Action if forensic community care order no longer appropriate- no longer person to whom ACAT could make order | Application for Revocation | 15162 |
| 7 | 105(1)(b) | Action if Forensic Psychiatric Treatment Order no longer appropriate | Written notice to the carer and/or Nominated person | 15140 |
| 7 | 106(1)(b) | Action if Forensic Psychiatric Treatment Order no longer appropriate to detain person | Written notice to the carer and/or Nominated person | 15140 |
| 7 | 112(1)(b) | Action if Forensic Community Care Order is no longer appropriate | Written notice to the carer and/or Nominated person | 15140 |
| 7 | 113(1)(b) | Action if Forensic Community Care Order no longer appropriate to detain person | Written notice to the carer and/or Nominated person | 15140 |
| 7 | 113(4) | Action if forensic community care order no longer appropriate- no longer necessary to detain | Application for Revocation | 15162 |
| 7 | 114 | Powers in relation to FCCO | Seclusion | 50010 |
| 7 | 114 | Powers in relation to FCCO | Seclusion/confinement observations | 60421 |
| 7 | 114 | Powers in relation to FCCO | Mechanical, Physical Restraint, or Forcible Giving of Medication Form | 35249 |
| 7 | 120 (1)a | Revocation of leave | Revocation of leave-forensic mental health orders | 15176 |
| 7 | 120(6) | Revocation of leave granted by ACAT | FMHO-Notification of Detention | 15150 |
| 7 | 121 | Grant of leave for person detained by relevant official | Leave whilst in detention-Forensic Mental Health orders | 15177 |
| 7 | 122 | Leave in emergency or special circumstances | Leave in emergency or special circumstances-FMHO | 15178 |
| 7 | 123(2) | Revocation of leave granted by relevant official | Revocation of leave-forensic mental health orders | 15176 |
| 7 | 123(6) | Revocation of leave granted by relevant official | FMHO-Notification of Detention | 15150 |
| 7 | 124(4) | Contravention of forensic mental health order | Wanted Person from a Secure Mental Health Facility | 15150 |
| 7 | 136 | Transfer to mental health facility | Request to Transfer a Detainee from a Place of Detention or Correctional Centre to DMHU | 36525 |
| 8 | 144A(3) | Transfer of custody if person admitted to secure mental health facility | Request to Transfer a Detainee from a Place of Detention or Correctional Centre to DMHU | 36525 |
| 8 | 144A (5) | Transfer of custody if person admitted to secure mental health facility | Request to Transfer a Detainee from a Place of Detention or Correctional Centre to DMHU | 36525 |
| 8 | 144A(7) | Transfer of custody if person admitted to secure mental health facility | Notification of Admission to DMHU | 20269 |
| 8 | 144A | Transfer of custody if person admitted to secure mental health facility | Transfer to from DMHU Security and Escort Risk assessment | 36526 |
| 8 | 144B | Taking person to appear before court | Transfer of custody between a place of detention or correctional centre and DMHU or DMHU and Court | 20274 |
| 8 | 144C | Release etc on change of status of person | Notification of Action following release from court ordered custody | 20272 |
| 8 | 144D | Power to apprehend if person escapes from secure mental health facility | Correctional Escapee from DMHU - Risk Assessment | 36501 |
| 8 | 144E | Transfer to mental health facility | Transfer from AMC | 15255 |
| 9 | 148 | Administration of Electroconvulsive Therapy - Adult with decision-making capacity | Electroconvulsive Therapy Consent and Prescription form | 15290 |
| 9 | 149 | Administration of Electroconvulsive Therapy - Adult with decision-making capacity | Electroconvulsive Therapy Consent and Prescription form | 15290 |
| 9 | 152 | Administration of Electroconvulsive Therapy - Young person without decision-making capacity | Electroconvulsive Therapy Consent and Prescription form | 15290 |
| 9 | 153 | Application for electroconvulsive therapy order | ACAT Electroconvulsive Therapy (ECT)-Application Form | AF2016-33 |
| 9 | 165 | Doctor must record electroconvulsive therapy | ECT Treatment Record | 50005 |