N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. VI, form 16-c
C.P.L. Article 730
FORM 16-c
12/88
DESIGNATION OF PSYCHIATRIC EXAMINERS
________ COURT OF ________
COUNTY OF ________
________x
PEOPLE OF THE STATE OF NEW YORK, DESIGNATION OF
PSYCHIATRIC
- against - EXAMINERS
Docket No. ________
________ Indictment No. ________
Defendant.
________x
The undersigned, having been directed by order signed by Honorable ________, (Judge) (Justice) of the ________ Court of ________ County, dated ________, to examine the above named defendant pursuant to Article 730 of the Criminal Procedure Law, does hereby designate ________, a qualified psychiatrist and ________ (a qualified psychiatrist) (a qualified psychologist) for the purpose of conducting the examination of said defendant, each to make a separate report of said examination.
Dated: ________
______________
Signature
______________
Printed Name
Director of Community Mental
Health Services, ____________ County
Director ____________ Hospital
N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. VI, form 16-c