Docket Case Monitoring Form

AOT Docket Case Monitoring Form

Judge: ____________________________________ Court Location: ________________________________ Date: ____________________

Respondent (StudyID)

Hearing Type

Respondent Attendance

Hearing Representatives

Hearing Length (Minutes)

Referral Source (Petition Only)

Substantial Verbal Interaction between Judge and Treatment Team

Hearing Outcome

Respondent Voluntariness (Petition or Renewal Only)

Warnings or Reminders (If Any)

Words of Encouragement (If Any)

Response to Noncompliance (If Any)

Next Hearing Date (Date)

Medication Modification Petition Pick-up Order Renewal/Expiration Revocation Treatment Plan Status

In Attendance Video Attendance Attendance Waived Not In Attendance

Legal counsel Probate Monitor/Court Liaison Treatment representative Guardian Family member Non-Family Member Advocate Other:

Family (parent, spouse, siblings, adult children, etc.) Outpatient mental health provider Residential facility Law enforcement officer Inpatient Criminal court Other Specify: __________

No Yes, minimal/low Yes, medium Yes, high

Willing to enter into new/ renewed AOT order Neutral to new/ renewed AOT order Contesting new/ renewed AOT order

Medication Modification Petition Pick-up Order Renewal/Expiration Revocation Treatment Plan Status

In Attendance Video Attendance Attendance Waived Not In Attendance

Legal counsel Probate Monitor/Court Liaison Treatment representative Guardian Family member Non-Family Member Advocate Other:

Family (parent, spouse, siblings, adult children, etc.) Outpatient mental health provider Residential facility Law enforcement officer Inpatient Criminal court Other Specify: __________

No Yes, minimal/low Yes, medium Yes, high

Willing to enter into new/ renewed AOT order Neutral to new/ renewed AOT order Contesting new/ renewed AOT order

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