§ 5227 — California Welfare and Institutions Code

The order for evaluation shall be in substantially the following form:

In the Superior Court of the State of California for the County of _____
The People of the State of California Concerning andRespondents	No. _____ Order for Evaluation
The People of the State of California to
:
(Professional person in charge of the facility providing evaluation)
______ has appeared before me and appears to be, as a result of ______ (chronic alcoholism, the use of narcotics, or the use of restricted dangerous drugs), a danger to himself, or others, or gravely disabled. Now, therefore, you are directed to evaluate ______ at ______ on the ____ day of __, 19, at __ o’clock _m. Witness my hand, this ____ day of __, 19.
Judge of the ________ Court
Return of Order
I hereby certify that I received the above order for the evaluation of ______ and on the ____ day of __, 19, personally served a copy of the order and of the petition on the professional person in charge of the ______, a facility for treatment and evaluation, or his designee.
Dated: ____ 19__.
Signature and Title

(Amended by Stats. 1970, Ch. 1129.)