AOC-SP-300 — Petition for Involuntary Commitment (Inpatient/IVC)

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01 PETITIONER INFORMATION

Petitioner Full Name *

Relationship to Respondent *

Petitioner Address *

Phone *

02 RESPONDENT INFORMATION

Respondent Full Name *

Date of Birth

Respondent Home Address

Respondent's Current Location *

County *

03 BASIS FOR PETITION — MENTAL ILLNESS

Description of Specific Behaviors Observed *

You must describe specific acts you personally witnessed or that were reported to you. General statements are not sufficient. The magistrate will evaluate whether these behaviors indicate mental illness.

04 DANGER TO SELF

Check all that apply:

Respondent has made suicidal statements or expressed intent to harm themselves

Respondent has made a suicide attempt or has engaged in self-injurious behavior

Respondent has harmed themselves or has injuries consistent with self-harm

Respondent is unable to care for themselves (food, shelter, hygiene) due to mental illness

Describe the Danger to Self (details, dates, specific acts):

05 DANGER TO OTHERS

Check all that apply:

Respondent has made explicit or implicit threats to harm another person

Respondent has committed physical acts of violence against another person

Respondent has access to weapons (firearms, knives, or other dangerous instruments)

Describe the Danger to Others (details, dates, specific acts):

06 ADDITIONAL CIRCUMSTANCES

Is the Respondent Currently Hospitalized?

Is Substance Use Involved?

07 EMERGENCY CONTACT FOR RESPONDENT

Emergency Contact Name

Relationship to Respondent

Emergency Contact Phone

08 PETITIONER CERTIFICATION

I certify that the facts set forth in this petition are true to the best of my knowledge and belief. I understand that a false statement in this petition may subject me to criminal penalties under G.S. 14-209.

Date of Petition *

SELECTED COUNTY

— Select above —

⚠ IF IMMEDIATE DANGER — CALL 911 FIRST

This form initiates a legal process, not an immediate emergency response. If the respondent is in immediate danger or actively threatening others, call 911 now. Call 988 (Suicide & Crisis Lifeline) for mental health crisis support.

WHO CAN FILE SP-300

Any person — family member, friend, neighbor, or member of the public
Law enforcement officer
Mental health provider or physician
No attorney required to file this petition

WHAT HAPPENS AFTER FILING

Magistrate reviews and may issue a custody order for evaluation (up to 24 hours)
Law enforcement transports respondent to an approved facility
Respondent has right to an attorney and to a hearing
If physician/psychologist recommends commitment, hearing within 10 days
Result: inpatient commitment order or release

STATUTORY REFERENCE

G.S. 122C-261Affidavit / custody order

G.S. 122C-263Examination at facility

G.S. 122C-268Inpatient commitment hearing

G.S. 122C-271Disposition; commitment order

NEED AN ATTORNEY?

Barker Richardson, PLLC represents respondents in IVC hearings across North Carolina.

CONTACT BARKER RICHARDSON →

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