(Style of Case)
NOTIFICATION OF PROBABLE CAUSE HEARING
On this the __________ day of __________, 20___, the undersigned hearing officer heard evidence concerning the need for protective custody of __________ (hereinafter referred to as proposed patient). The proposed patient was given the opportunity to challenge the allegations that the proposed patient presents a substantial risk of serious harm to self or others.
The proposed patient and the proposed patient's attorney _____________ have been given written notice that the proposed
(attorney)
patient was placed under an order of protective custody and the reasons for such order on _________________.
(date of notice)
I have examined the certificate of medical examination for chemical dependency and ________________________________. Based on
(other evidence considered)
this evidence, I find that there is probable cause to believe that the proposed patient presents a substantial risk of serious harm to self (yes ___ or no ___) or others (yes ___ or no ___) such that the proposed patient cannot be at liberty pending final hearing because
________________________________________________________________
(reasons for finding; type of risk found)
Tex. Health and Safety Code § 462.066