Statement of Noncompliance with Order for Involuntary Administration of Psychotropic Medication

This form is used to tell the court that a person under the court's care is not following an order about taking certain medications. It asks the court to give permission for law enforcement to take the person and bring them to a facility to receive the medication using physical restraint.

The court describes it as: Statement of Noncompliance with Order for Involuntary Administration of Psychotropic Medication.

Official instructions

How-to guides published by the court for this form.

• Plain-language summary↗

Common questions

Who fills out this form?

The form requires signatures from the Corporation Counsel, the Guardian, and the Director or Designee of the County Department or Agency that manages the treatment plan.

What does this form ask the court for?

It asks the court to issue an order allowing law enforcement to take the person into custody and transport them to a facility for medication administration using physical restraint.

Revision history

No changes recorded since we started tracking this form on October 10, 2026. The current version took effect May 30, 2024.

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