"If you decline psychiatric treatment described in the general treatment plan or demand to be discharged you may be required to appear at an involuntary civil commitment hearing. It is your right to request an involuntary civil commitment hearing at this time. If a judge finds you to be a person with mental illness you may be civilly committed for up to 180 days. However, if a judge finds you not to be a person with mental illness you may be released. The treatment in which you were to participate as a condition of avoiding a commitment hearing is described in your general treatment plan. You were given a copy of your general treatment plan when you agreed to diversion. You may see the copy of your general treatment plan on file with this facility at any time. You may talk with your attorney before you decline this treatment, demand discharge, or request a hearing."
"Warning
If you decline psychiatric treatment described in your general treatment plan or demand discharge you may be required to appear at an involuntary civil commitment hearing. You have a right to request an involuntary civil commitment hearing at this time. If a judge finds you to be a person with mental illness you may be civilly committed for up to 180 days. The psychiatric treatment in which you were to participate as a condition of avoiding a civil commitment hearing is described in your general treatment plan. You were given a copy of your general treatment plan when you agreed to diversion. You may see the copy of your general treatment plan on file with this facility at any time. You may talk with your attorney before you decline this treatment, demand discharge, or request a hearing.
I decline the treatment described in my general treatment plan.
I request a hearing before the circuit court.
_____________________________
Signature of Certified Person Alleged to Have a Mental Illness."
Or. Admin. Code § 309-033-0260
Statutory/Other Authority: ORS 413.042, 426.236 & 426.237
Statutes/Other Implemented: ORS 426.005 - 426.395