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JV-220Mandatory

Application For Psychotropic Medication

California · Judicial Council of California · Effective January 1, 2018

This form is used to give the court basic information about a child and their living situation when asking for medication that affects mental health. It collects details about the child, where they live, and information from medical and social service staff.

The court describes it as: The social worker or probation officer uses this to give the court basic information about the child and their living situation.

Open the official PDFfrom Judicial Council of California

Where this fits in a case

Start a case

Stage: Start a case

This form is used when a social worker or probation officer needs to provide the court with information regarding a child and a request for psychotropic medication.

Prepared by the court or clerk.

Official instructions

How-to guides published by the court for this form.

Common questions

Who must fill out this form?
If you are the child's social worker or probation officer, you must fill out items 5 through 13. If you are not, you do not need to fill out those items.
Are other forms needed?
A completed and signed Physician’s Statement (form JV-220(A)) or Physician’s Request to Continue Medication (form JV-220(B)) must be attached before filing.
What information is collected?
The form collects details about the child's living situation, the child's current location, and information about medications the child has taken in the past.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect January 1, 2018.

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