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Here is the text we could read:

ATTORNEY OR PARTY WITHOUT ATTORNEY

STATE BAR NUMBER:

HC-002

FOR COURT USE ONLY

NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

TELEPHONE NO.:

E-MAIL ADDRESS:

ATTORNEY FOR (name):

STATE:

FAX NO.:

ZIP CODE:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

IN THE MATTER OF (NAME) :

PETITION FOR WRIT OF HABEAS CORPUS—LPS ACT

Petitioner

CASE NUMBER:

1. Petitioner is being unlawfully restrained of liberty at (specify name of treatment facility):

by (specify name of agency and treating psychiatrist):

2. Petitioner was admitted to the treatment facility on (date):

and is currently being held pursuant to

W & I, § 5150 (72-hour hold)
W & I, § 5270.15 (30-day cert.)
W & I, § 5350 (conservatorship)
Other (specify):

W & I, § 5250 (14-day certification)
W & I, § 5300 (180-day post certification)
W & I, § 5352.1 (temporary conservatorship)

W & I, § 5260 (2d 14-day certification)

3.  Check at least one box:

a.

Petitioner is illegally confined for the following reason:

b.

Petitioner has been denied the following rights without good cause (Welf. & Inst. Code, §§ 5325, 5325.1,  and 5326):

4. 

Petitioner requests that this court (check all that apply):

Issue a Writ of Habeas Corpus to the director of the facility named in item 1, commanding that the petitioner be 
brought before this court at a specified time and place.
Order the facility to release petitioner from restraint.

Order that all rights to which petitioner is entitled as a patient be observed.

Grant such other relief as this court deems appropriate.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

a.

b.

c.
d.

Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF PETITIONER OR PERSON REQUESTING WRIT ON PETITIONER'S BEHALF)

Form Approved for Optional Use  
Judicial Council of California 
HC-002 [Rev. September 1, 2018]

PETITION FOR WRIT OF HABEAS CORPUS—LPS ACT 
(Mental Health)

Page 1 of 1

 www.courts.ca.gov.

Petition for Writ of Habeas Corpus—LPS Act (Mental Health)

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 1
Fields(s): 37
Average fields per page: 37
Reading Level: Grade 7
LIST Grouping(s): CO-00-00-00-00, CO-07-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

topmost_subform_page_confinement__1 was topmostSubform[0].Page1[0].Confinement[0] (0.60 conf)
topmost_subform_page_line_r was topmostSubform[0].Page1[0]._3LineTR12\.0[0] (0.40 conf)
topmost_page_certification__1 was topmostSubform[0].Page1[0].Certification[0] (0.38 conf)
topmost_subform_page_tex_larg_e__1 was topmostSubform[0].Page1[0].TEXT_LARGE\.0[0] (0.41 conf)
topmost_subform_page_tex_larg_e__2 was topmostSubform[0].Page1[0].TEXT_LARGE\.1[0] (0.41 conf)
page_caption_sf_court_county was topmostSubform[0].Page1[0].Caption_sf[0].CourtInfo[0].CrtCounty_ft[0] (0.36 conf)
page_caption_title_name_text was topmostSubform[0].Page1[0].Caption_sf[0].TitlePartyName[0].FillText1[0] (0.43 conf)
topmost_subform_page_caption_sf_case_number_ft was topmostSubform[0].Page1[0].Caption_sf[0].CaseNumber[0].CaseNumber_ft[0] (0.42 conf)
topmost_subform_page_caption_sf_atty_info_state_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].AttyState_ft[0] (0.43 conf)
topmost_subform_page_caption_sf_atty_info_zip_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].AttyZip_ft[0] (0.36 conf)
topmost_subform_page_caption_sf_atty_info_city_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].AttyCity_ft[0] (0.40 conf)
topmost_subform_page_caption_sf_atty_info_street_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].AttyStreet_ft[0] (0.37 conf)
topmost_subform_page_caption_sf_atty_info_firm_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].AttyFirm_ft[0] (0.42 conf)
topmost_subform_page_caption_sf_atty_info_name_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].AttyName_ft[0] (0.40 conf)
topmost_subform_page_caption_sf_atty_info_phone_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].Phone_ft[0] (0.39 conf)
topmost_subform_page_caption_sf_atty_info_fax_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].Fax_ft[0] (0.41 conf)
topmost_subform_page_caption_sf_atty_info_email_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].Email_ft[0] (0.45 conf)
topmost_subform_page_caption_sf_atty_info_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].AttyFor_ft[0] (0.38 conf)
topmost_subform_page_caption_sf_atty_info_bar_ft was topmostSubform[0].Page1[0].Caption_sf[0].AttyInfo[0].BarNo_ft[0] (0.41 conf)
topmost_subform_page_fill_text__1 was topmostSubform[0].Page1[0].FillText1[0] (0.44 conf)
topmost_subform_page_fill_text__2 was topmostSubform[0].Page1[0].FillText1[1] (0.44 conf)
topmost_page_date_field__1 was topmostSubform[0].Page1[0].DateField1[0] (0.40 conf)
topmost_page_certification__2 was topmostSubform[0].Page1[0].Certification[1] (0.38 conf)
topmost_page_certification__3 was topmostSubform[0].Page1[0].Certification[2] (0.38 conf)
topmost_page_certification__4 was topmostSubform[0].Page1[0].Certification[3] (0.38 conf)
topmost_page_certification__5 was topmostSubform[0].Page1[0].Certification[4] (0.38 conf)
topmost_page_certification__6 was topmostSubform[0].Page1[0].Certification[5] (0.38 conf)
topmost_page_certification__7 was topmostSubform[0].Page1[0].Certification[6] (0.38 conf)
topmost_page_certification__8 was topmostSubform[0].Page1[0].Certification[7] (0.38 conf)
topmost_subform_page_confinement__2 was topmostSubform[0].Page1[0].Confinement2[0] (0.38 conf)
topmost_subform_page_order__1 was topmostSubform[0].Page1[0].Order[0] (0.38 conf)
topmost_page_area_order was topmostSubform[0].Page1[0].#area[0].Order2[0] (0.38 conf)
topmost_subform_page_order__2 was topmostSubform[0].Page1[0].Order3[0] (0.38 conf)
topmost_subform_page_order__3 was topmostSubform[0].Page1[0].Order4[0] (0.38 conf)
topmost_subform_page_order__4 was topmostSubform[0].Page1[0].Order5[0] (0.38 conf)
topmost_page_date_field__2 was topmostSubform[0].Page1[0].DateField1[1] (0.40 conf)
topmost_subform_page_fill_text__3 was topmostSubform[0].Page1[0].FillText56[0] (0.44 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Petition for Writ of Habeas Corpus—LPS Act (Mental Health)

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02