I. The petition for admission on an involuntary basis shall include:
(a) The name of the person sought to be admitted and his last known address.

Terms Used In New Hampshire Revised Statutes 135-C:36

  • Advanced practice registered nurse: or "APRN" means an advanced practice registered nurse licensed by the board of nursing who is certified as a psychiatric mental health nurse practitioner by a board-recognized national certifying body. See New Hampshire Revised Statutes 135-C:2
  • Commissioner: means the commissioner of the department of health and human services. See New Hampshire Revised Statutes 135-C:2
  • Community mental health program: means a program established and administered by the state, city, town, or county, or a nonprofit corporation for the purpose of providing mental health services to the residents of the area and which minimally provides emergency, medical or psychiatric screening and evaluation, case management, and psychotherapy services. See New Hampshire Revised Statutes 135-C:2
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • person: may extend and be applied to bodies corporate and politic as well as to individuals. See New Hampshire Revised Statutes 21:9
  • petition: when used in connection with the equity jurisdiction of the superior court, and referring to a document filed with the court, shall mean complaint, and "petitioner" shall mean plaintiff. See New Hampshire Revised Statutes 21:51
  • petitioner: shall mean plaintiff. See New Hampshire Revised Statutes 21:51
  • Physician: means a medical doctor licensed to practice in New Hampshire. See New Hampshire Revised Statutes 135-C:2
  • Physician assistant: or "PA" means a physician assistant licensed to practice in New Hampshire. See New Hampshire Revised Statutes 135-C:2
  • Receiving facility: means a treatment facility which is designated by the commissioner to accept for care, custody, and treatment persons involuntarily admitted to the state mental health services system. See New Hampshire Revised Statutes 135-C:2
  • Testify: Answer questions in court.

(b) The specific acts or actions that the petitioner alleges satisfy N.H. Rev. Stat. § 135-C:34.
(c) A certificate from a physician, physician assistant, or advanced practice registered nurse who is approved by either a designated receiving facility or a community mental health program approved by the commissioner, who has examined the person sought to be admitted within 5 days of the date the petition is filed and who agrees that, based on this examination, such person satisfies the standard set forth in N.H. Rev. Stat. § 135-C:34.
(d) The names and addresses of witnesses who can testify to the occurrence of the specific acts or actions of the person sought to be admitted which the petitioner alleges will satisfy the requirements of N.H. Rev. Stat. § 135-C:34.
II. The certificate of the examining physician, physician assistant, or advanced practice registered nurse made upon admission, if the person sought to be admitted is currently voluntarily admitted to a receiving facility, or a certificate of the examining physician, physician assistant, or advanced practice registered nurse made prior to the admission of the person sought to be admitted to involuntary emergency admission in accordance with N.H. Rev. Stat. § 135-C:27-33, shall be sufficient as the certificate for the petition for involuntary admission, if made within 5 days of the date of the filing of the petition.
III. The petition for admission on an involuntary basis may include a request for appointment of a guardian over the person for the limited purpose of providing for the respondent’s health care. If such a request is made, the petition shall include:
(a) The petitioner’s connection with or relationship to the respondent;
(b) When appropriate, the name and address of the person or institution having care or custody over the respondent;
(c) The names and addresses of adult spouses, parents, children and siblings of the respondent, so far as they are known to the petitioner;
(d) The name, address, occupation and relationship to the respondent, if any, of the proposed guardian; and
(e) A statement containing facts which show the necessity for appointment of a guardian of the person for the purpose of providing health care, including specific allegations as to the respondent’s personal actions or actual occurrences which are claimed to demonstrate his or her inability to provide for personal needs for health care.