<p> IN THE CIRCUIT COURT OF THE STATE OF OREGON 1 FOR THE COUNTY OF [EXAMPLE]</p><p>2 IN THE MATTER OF THE COMMITMENT ) Case No. THX-3118 ) 3 OF ) ORDER AND STIPULATED GENERAL ) JUDGEMENT OF COMMITMENT 4 JOHN F. DOE ) ) 5 AN ALLEGED MENTALLY ILL PERSON ) ) 6 THIS MATTER came before the Court for hearing on [date], [year], pursuant to ORS 7 426.701 et seq. The State of Oregon appeared by and through [County] County Deputy District 8 Attorney [Name]. John F. Doe, the alleged mentally ill person, and his attorney [Name] appeared 9 via video conferencing. Based upon the stipulation of the parties, and the Court having reviewed 10 the Oregon State Hospital notes of [Doctor]. Attached and hereby incorporated by reference, the 11 Court makes the following FINDINGS OF FACT based upon clear and convincing evidence: 12 (1) John F. Doe is an extremely person in that he is: 13 (a) At least eighteen years of age; 14 (b) Exhibiting symptoms or behaviors of a mental disorder substantially 15 similar to those that preceded his [instant offense]; 16 (c) Suffering from a mental disorder which causes him to present a serious 17 danger to the safety of other persons by reason of an extreme risk to 18 the safety of other persons in the foreseeable future; 19 (2) John F. Doe suffers from a mental disorder, to wit [details of psychiatric 20 diagnosis], that is resistant to treatment; 21 (3) Because of the mental disorder that is resistant to treatment, John F. Doe 22 caused [details of instant offense]. 23 (4) At this time, John F. Doe cannot be controlled in the community cannot be 24 controlled in the community with proper care, 25</p><p>26 Page 1 – STIPULATION AND AGREEMENT 1 medication, supervision and treatment on conditional release.</p><p>2 (5) The Court has been fully advised of all drugs and other treatment known to</p><p>3 have been administered to John F. Doe that may substantially affect his ability</p><p>4 to prepare for, or to function effectively at, the hearing; and,</p><p>5 (6) John F. Doe has been advised, in writing, of these allegations, his right to a</p><p>6 hearing, and the rights listed in ORS 426.701(2)(c).</p><p>7 (7) John F. Doe, after consultation with his attorney [name], stipulates to</p><p>8 commitment under ORS 426.701 et seq.</p><p>9 (8) If applicable: There is no substantial probability that John F. Doe, in the</p><p>10 foreseeable future, will gain or regain the capacity to stand trial. The</p><p>11 indictment in [County] County Circuit Court number [#] is therefore to be</p><p>12 dismissed, without prejudice, under ORS 161.370(10).</p><p>13 (9) [Guardian] has been appointed John F. Doe’s guardian.</p><p>14 (10) If applicable: [Name of Victim of Instant Offense] [does / does not] desire</p><p>15 notification of hearings, conditional release, discharge or escape of person</p><p>16 committed under this order.</p><p>17 (11) [If applicable, add no contact of victims] That, John F. Doe shall not have</p><p>18 direct, indirect or third party contact with [Names/Initials of Victims].</p><p>19 IT IS NOW HEREBY ORDERED AND ADJUDGED that John F. Doe be committed to</p><p>20 the jurisdiction of the:</p><p>21 (1) Psychiatric Security Review Board for a maximum of twenty-four months,</p><p>22 except that the commitment may be continued under the provisions of ORS 426.702;</p><p>23 (2) Oregon State Hospital for care, custody and treatment.</p><p>24 DATED: ___ day of [Month], 2016</p><p>25</p><p>26 Page 2 – STIPULATION AND AGREEMENT ______1 Circuit Court Judge</p><p>2</p><p>3 IT IS HEREBY STIUPLATED TO AND AGREED TO BY:</p><p>4 ______Name 5 Deputy District Attorney</p><p>6 ______7 Name 8 Attorney for John F. Doe</p><p>9 ______10 Name John F. Doe 11 Respectfully submitted by: 12 Client’s Attorney, OSB No. # Attorney for John F. Doe. 13</p><p>14</p><p>15</p><p>16</p><p>17</p><p>18</p><p>19</p><p>20</p><p>21</p><p>22</p><p>23</p><p>24</p><p>25</p><p>26 Page 3 – STIPULATION AND AGREEMENT</p>