Welf. & Inst. Code, § 6251

Wherever, on the basis of a petition, provision is made in this code for issuing and delivering an order for examination and detention directing that a person be apprehended and taken before a judge of a superior court for a hearing and examination on an allegation of being a person subject to judicial commitment, the petition shall be in substantially the following form:

In the Superior Court of the State of California For the County of____

The People For the Best Interest and Protection of ______ ⎫ ⎪ ⎪

as a ______ ⎪

and Concerning ______ and ⎬ ⎪ Petition

______ ⎪

______Respondents ______ ⎪ ⎭

_______, residing at ______ (tel. _______), being duly sworn deposes and says: That there is now in the county in the City or Town of __________

a person named ______, who resides at ______, and who is believed to be a ______. That the person is ____ years of age; that __ the person is ____ (sex) and that __ the person is ____ (single, married, widowed, or divorced); and that ____ occupation is ____.

That the facts because of which petitioner believes that the person is a ____ are as follows: That __ the person, at _______ in the county, on the____ day of ____, 20__, ______ That petitioner’s interest in and case is ______ ______

That petitioner believes that said person is ____ as defined in Section ____. That the persons responsible for the care, support, and maintenance of the ____, and their relationship to the person are, so far as known to the petitioner, as follows: (Give names, addresses, and relationship of persons named as respondents)

Wherefore, petitioner prays that examination be made to determine the state of the mental health of ____, alleged to be ____, and that such measures be taken for the best interest and protection of said ____, in respect to the person’s supervision, care and treatment, as may be necessary and provided by law. ______Petitioner Subscribed and sworn to before me this ____ day of ______, 20__. ________________________________, Clerk of the Court By _____________________________________________ Deputy