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DC-489

Medical Emergency Temporary Detention Petition

Virginia · Supreme Court of Virginia

This form is a petition used to ask the court for temporary detention for someone who needs medical care. It requires a licensed medical professional to state that the person cannot make a clear decision about treatment.

Open the official PDFfrom Supreme Court of Virginia

Where this fits in a case

Start a case

Stage: Start a case

This form is used when a licensed physician, psychiatrist, or clinical psychologist believes a person needs immediate medical testing, observation, or treatment because they are unable to give informed consent.

Usually filed by the person starting the case.

Common questions

Who fills out this form?
The form must be filled out by a licensed physician, psychiatrist, or clinical psychologist. This person is the petitioner.
What does this form ask the court for?
It asks the court to approve temporary detention for a person to receive necessary medical testing, observation, or treatment.
Does this form require a fee?
The provided text does not mention any filing fees for this form.

Revision history

No changes recorded since we started tracking this form on October 10, 2026.

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