Commitment Under Physician's Emergency Certificate:

Under §17a-502, a person may be confined for up to 15 days without a court order, pursuant to a physician's emergency certificate. The physician must have concluded that the person has psychiatric disabilities and is a danger to himself or others or gravely disabled, and needs immediate care and treatment in a hospital for psychiatric disabilities.  The certificate must state (1) the date of examination, which shall not be more than three days prior to the date of the certificate; (2) the physician’s findings relative to the person’s physical and psychiatric condition and the history of the case, if known; (3) the physician’s opinion that the person has psychiatric disabilities and is dangerous to himself or others or gravely disabled and needs immediate care and treatment in a hospital for psychiatric disabilities; and (4) the reasons for his opinion (CGS § 17a-502(a)).

If a written application for commitment has been filed in probate court prior to the expiration of the 15 days, the emergency commitment may be continued for an additional 15 days or until completion of probate proceedings, whichever is sooner (CGS § 17a-502(a)).  Any person admitted on an emergency basis must be examined by a psychiatrist within 24 hours of admission.  If the psychiatrist determines that the person does not meet the criteria for emergency detention and treatment, he must be released (CGS § 17a-502(b)).

Physician's Certificate and Five Day (5) Emergency Commitment Application (FAC-14)

Physician's Emergency Certificate - Fifteen Day (15)

Completed forms may be emailed to EBPadmin@ct.gov.