Ariz. Admin. Code § R9-21-503 - Voluntary Admission for Evaluation

A. An application for voluntary evaluation pursuant to A.R.S. § 36-522 shall be submitted on AHCCCS form MH-103, Titled "Application for Voluntary Evaluation," set forth in Exhibit D to a mental health agency.

B. If a health plan receives an application according to subsection (A), the health plan shall provide for such evaluation under A.R.S. § 36-522 for any individual who:

1. Voluntarily makes application as provided in subsection (A);

2. Gives informed consent; and

3. Has not been adjudicated as an incapacitated person pursuant to A.R.S. Title 14, Chapter 5, or Title 36, Chapter 5.

C. Any mental health agency, which is not a health plan under R9-21-501, that receives an application for voluntary evaluation shall immediately refer the individual to:

1. The county responsible for voluntary evaluations; or

2. If the county has contracted with a health plan for voluntary evaluations, the appropriate health plan.

D. Any mental health agency providing voluntary evaluation services pursuant to this Article shall place in the medical record of the individual to be evaluated the following:

1. A completed copy of the application for voluntary treatment;

2. A completed informed consent form pursuant to R9-21-511; and

3. A written statement of the individual's present mental condition.

E. Voluntary evaluation shall proceed only after the individual to be evaluated has given informed consent on AHCCCS form MH-103 and received information that the patient-physician privilege does not apply and that the evaluation may result in a petition for the individual to undergo court-ordered treatment or for guardianship in the method prescribed by A.R.S. § 36-522.

Notes

Ariz. Admin. Code § R9-21-503

Adopted under an exemption from A.R.S. Title 41, Chapter 6 pursuant to Laws 1992, Ch. 301, § 61, effective October 7, 1992; received in the Office of the Secretary of State October 14, 1992 (Supp. 92-4). Former Section R9-21-503 renumbered to R9-21-502; new Section R9-21-503 renumbered from R9-21-504 and amended by exempt rulemaking at 9 A.A.R. 3296, effective June 30, 2003 (Supp. 03-2). Amended by final rulemaking at 29 A.A.R. 898, effective 5/30/2023.