Tip for Baker Act (CF-MH 3001-3100 series)

The Baker Act examination is limited to 72 hours — longer treatment requires a separate petition for involuntary placement

Tip for Baker Act (CF-MH 3001-3100 series)

Any adult can file a Baker Act petition with the court, but a judge must review and approve it

Tip for Baker Act (CF-MH 3001-3100 series)

Law enforcement and certain mental health professionals can initiate a Baker Act without a court order

Behavioral HealthhardDoctor signature required

Florida Baker Act Petition

Baker Act (CF-MH 3001-3100 series) · Florida Department of Children and Families

Florida-specific involuntary examination petition under the Baker Act. Allows 72-hour hold for psychiatric evaluation when a person meets criteria for involuntary examination.

Form Details

Total fields: 30
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Filled by: doctor
Frequency: as needed
State-specific: Yes — form may vary by state

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Where to Submit This Form

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File with the circuit court clerk in the county where the person is located

Florida-specific: Baker Act petitions can also be initiated by law enforcement, physicians, or licensed mental health professionals without a court order.

Filing Deadline

File when there is reason to believe a person has a mental illness and is at imminent risk of harm. Involuntary examination is limited to 72 hours.

Required Attachments

📎 Baker Act petition form (Florida-specific form CF-MH 3001 or court form)
📎 Detailed description of behaviors and statements indicating mental illness and danger
📎 Specific facts observed by the petitioner, including dates, times, and circumstances
📎 Petitioner's sworn statement

Processing Time

Court review: typically within 24 hours of filing. Law enforcement/professional-initiated: immediate. The 72-hour examination period begins upon arrival at the receiving facility.

What Happens Next

The individual will be transported to a Baker Act receiving facility for involuntary examination. A psychiatrist must examine the person within 72 hours. The person may be released, convert to voluntary status, or the facility may petition for extended involuntary treatment.

Tips for This Form

✓ The Baker Act examination is limited to 72 hours — longer treatment requires a separate petition for involuntary placement
✓ Any adult can file a Baker Act petition with the court, but a judge must review and approve it
✓ Law enforcement and certain mental health professionals can initiate a Baker Act without a court order
✓ The individual has the right to contact an attorney, a patient advocate, and family members during the examination

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Special consent required under federal law (42 CFR Part 2) for disclosure of substance use disorder treatment records. More restrictive than standard HIPAA authorization. Requires specific elements including prohibition on re-disclosure.

Petition for Involuntary Examination

Baker Act / 5150 / Section 12 (state-specific) · State Courts / Law Enforcement / Providers

Legal petition for involuntary psychiatric examination of a person believed to meet criteria for danger to self/others or grave disability. Known by different names: Baker Act (FL), 5150 (CA), Section 12 (MA), and other state-specific designations.

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the Florida Department of Children and Families or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.