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South Carolina Department of Mental Health

Mission: To support the recovery of people with mental illnesses.

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Commitment Forms

Commitment Forms

Below are commitment forms that were cooperatively drafted by a committee of probate judges and SCDMH and implemented in 2018. The forms are in a fillable Word format. 

    • Memorandum to Hospitals and Mental Health Facilities
    • M-130: Affidavit for Involuntary Emergency Hospitalization for Mental Illness and Order of Detention
    • M-131: Certificate of Licensed Physician Examination for Emergency Admission
    • M-132: Designated Examiner for Mental Illness Report
    • M-133: Notification of Emergency Admission Appointment of Designated Examiners
    • M-134: Aff for Inv Emg Hosp for Chemical Dependency
    • M-136: Part II Certificate of licensed Physician Medical Examination for Chemical Dependency
    • M-137: Report of Designed Examiner for Chemical Dependency
    • M-138: Notification of Emergency Adm for Chemical Dependency
    • M-013: Petition For Judicial Admission of a Child
    • M-014: Notice of Petition for Judicial Admission & Notice of Right to Counsel
    • M-015: Application for Child in Need of Emergency Admission
    • M-017: Part II Certificate of Licensed Physician Examination of Child in Need of Emergency Admission
    • M-019: Report of Designated Examiner for a Child
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