PART D THE MANAGING AUTHORITY’S REASONS — Explain here: (a) the nature of the restrictions on the person’s liberty that lead to the conclusion that they are deprived of their liberty (b) why the care and/or treatment described cannot be provided in a way that is less restrictive of the person’s rights and freedom of action (c) to the extent that the managing authority is aware, what alternatives to deprivation of liberty have been considered (d) what harm the person is likely to come to if they are not immediately deprived of their liberty in this hospital or care home (e) why the need to deprive the person of their liberty is so urgent that it is appropriate for the deprivation to begin immediately. The managing authority’s reasons for giving an urgent authorisation are as follows: PART E NEED FOR AN INDEPENDENT MENTAL CAPACITY ADVOCATE (IMCA) — Place a cross in one of the boxes below As far as the managing authority are aware, apart from professionals and other people who are paid to provide care or treatment, this person has no one whom it is E1 appropriate to consult about what is in their best interests The managing authority believes that there is someone it is appropriate to consult about what is in this person’s best interests who is neither a professional nor is being E2 paid to provide care or treatment. RELEVANT MEDICAL INFORMATION Medical information relating to the person’s health that the managing authority considers to be relevant to the proposed restrictions to the person’s liberty: DIAGNOSIS OF THE MENTAL DISORDER
PART D — THE MANAGING AUTHORITY’S REASONS Explain here: (a) the nature of the restrictions on the person’s liberty that lead to the conclusion that they are deprived of their liberty (b) why the care and/or treatment described cannot be provided in a way that is less restrictive of the person’s rights and freedom of action (c) to the extent that the managing authority is aware, what alternatives to deprivation of liberty have been considered (d) what harm the person is likely to come to if they are not immediately deprived of their liberty in this hospital or care home (e) why the need to deprive the person of their liberty is so urgent that it is appropriate for the deprivation to begin immediately. The managing authority’s reasons for giving an urgent authorisation are as follows: PART E — NEED FOR AN INDEPENDENT MENTAL CAPACITY ADVOCATE (IMCA) Place a cross in one of the boxes below E1 As far as the managing authority are aware, apart from professionals and other people who are paid to provide care or treatment, this person has no one whom it is appropriate to consult about what is in their best interests E2 The managing authority believes that there is someone it is appropriate to consult about what is in this person’s best interests who is neither a professional nor is being paid to provide care or treatment. RELEVANT MEDICAL INFORMATION Medical information relating to the person’s health that the managing authority considers to be relevant to the proposed restrictions to the person’s liberty: DIAGNOSIS OF THE MENTAL DISORDER
combined_dols_forms_1_and_4.docx