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PCM 233Mandatory

Notice of Right to Appeal Return and Appeal of Return from Authorized Leave

Michigan · Michigan State Court Administrative Office · Effective February 1, 2019

This form is a notice that tells someone they have the right to appeal their return to a hospital or facility after being on authorized leave. It asks the person who received it to notify the court if they want to appeal and have a hearing.

The court describes it as: Court rule / statute: MCL 330.1408(3), MCL 330.1537(3), MCR 5.743, MCR 5.743a, MCR 5.743b

Open the official PDFfrom Michigan State Court Administrative Office

Where this fits in a case

Appeal

Stage: Appeal

This form is used when an individual has been on authorized leave from a hospital or facility for more than 10 days and is then returned to the facility against their will.

Either party may file.

Common questions

Who receives this notice?
This notice is given to an individual who has been on authorized leave from a hospital or facility for more than 10 days and was then returned involuntarily.
What must be done if the person wants to appeal?
If the person wishes to appeal, they must notify the court within 7 days after receiving this notice.
Who must file the appeal if the person is a child?
If the person appealing is a child under 13 years old, the appeal must be made by the parent or guardian.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect February 1, 2019.

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