Petitioner's Name: (person filling out this form)
SUBJECT OF PETITION:
Subject's Name: (person in need of treatment)
Date of Birth:
Address: (must be in Milwaukee County)
Does the subject have a mental illness?
If yes, what illness(es)?
Was the subject prescribed any medications?
Is the subject taking them?
Does the subject have a drug dependency/addiction?
If yes, to what drug(s)?
How often is the subject using?
VIOLENT OR DANGEROUS EVENTS:
To file a Three-Party Petition, all petitioners must have seen the subject within the past 60 days doing things that were dangerous and/or violent. This includes actual violence, threats to harm himself/herself or others, gathering weapons, or careless acts that put himself/herself or others in danger of getting hurt. It does not include behavior that was loud, angry, or delusional, but did not include any violence or threats.
Please list and describe each event of the subject’s dangerous, threatening, or violent behavior that you have personally seen within the past 60 days. Do not list older events or events you heard about from other people. Include as much detail about each event as you can remember.
- If you have seen more than three dangerous or violent events in the past 60 days, just list the three most dangerous events you saw.
- If you are not sure of the date of an event, saying “on or around” a date is fine.
- If the subject is living somewhere outdoors, unsanitary, unheated, abandoned, or unsafe, you may email any photos you have of the subject’s living space to CorporationCounsel3PartyPetitions@milwaukeecountywi.gov.
If you have any photos or additional event descriptions to give us, please email them to CorporationCounsel3PartyPetitions@milwaukeecountywi.gov.