RULE 6.3                                               
       PETITION FOR NINETY-DAY INVOLUNTARY TREATMENT                             
                                                                                 
    The petition for 90-day involuntary treatment shall contain the              
following:                                                                       
    (a) The name and address of the petitioner.                                  
    (b) The name and address of the person alleged, as a result of mental        
disorder, to present a likelihood of serious harm to him/herself or others       
because such person (1) has threatened, attempted, or inflicted physical         
harm upon the person of another or him/herself or substantial damage upon        
the property of another after having been taken into custody for evaluation      
and treatment, or (2) was taken into custody as a result of conduct in           
which he/she attempted or inflicted physical harm upon the person of             
another or him/herself, or (3) is gravely disabled, or (4) has been              
determined to be incompetent and criminal charges have been dismissed            
pursuant to RCW 10.77.090(3) and has committed acts constituting a felony,       
and presents substantial likelihood of repeating similar acts. Such person       
shall be denominated the respondent.                                             
    (c) A statement that petitioner is the professional person in charge of      
the treatment facility in which the respondent is detained pursuant to           
court order or his professional designee, or the county mental health            
professional of (name) County.                                                   
    (d) The name of the court ordering 14-day involuntary treatment or           
finding the respondent incompetent pursuant to RCW 10.77.090(3) and the          
date on which such order or finding was entered.                                 
    (e) A summary of the facts supporting the allegations of the petition.       
    (f) A demand that a hearing be held within 5 judicial days of the first      
court appearance after the probable cause hearing unless the person named        
in the petition requests a jury trial, in which case trial shall commence        
within 10 judicial days of the filing of the petition for 90-day treatment       
on the issue of whether the person alleged, as a result of mental disorder,      
to present a likelihood of serious harm, to himself or others, shall be          
detained for involuntary treatment for a period not to exceed 90 days.           
    (g) A statement that the petition is supported by accompanying               
affidavits and the names of the persons signing such affidavits.                 
    (h) The petition shall be in substantially the following form:               
                                                                                 
                SUPERIOR COURT OF WASHINGTON                                     
                FOR (_______________) COUNTY                                     
                                                                                 
In re the Detention of:   )               No. __________                         
                          )                                                      
                          )               PETITION FOR NINETY-DAY                
                          )               INVOLUNTARY TREATMENT                  
                          )                                                      
     Respondent.          )               RCW __________                         
                                                                                 
(Petitioner), ___ the professional person in charge, or ___ his                  
professional designee, or ___ the county mental health professional for          
(name) county, of (name of facility) in which (respondent) is detained for       
(number) days pursuant to an order of (name of court) entered on (date)          
alleges that:                                                                    
    (Respondent), residing at (address) in (city or town), is a                  
___ single ___ married ___ widowed ___ divorced ___ male ___ female              
age _____.                                                                       
    As a result of mental disorder (respondent) presents a likelihood of         
serious harm to him/herself or others because respondent ___ has                 
threatened, attempted, or inflicted physical harm upon the person of             
another or him/herself or substantial damage upon the property of another        
after having been taken into custody for evaluation and treatment, or ___        
was taken into custody as a result of conduct in which respondent                
threatened, attempted or inflicted physical harm upon the person of another      
or him/herself, or ___ is gravely disabled, or ___ has been determined to        
be incompetent and criminal charges have been dismissed pursuant to RCW          
10.77.090(3), and has committed acts constituting a felony, and as a result      
of mental disorder, presents a substantial likelihood of repeating similar       
acts.                                                                            
    The facts upon which the allegations of this petition are based              
are summarized as follows: ___________________________________________           
______________________________________________________________________           
    The allegations are supported by the accompanying affidavits                 
signed by ___________________________________________________________.           
    The petitioner requests that a hearing be held to determine whether          
(respondent) shall be detained for involuntary treatment for a period not        
to exceed 90 days.                                                               
    Dated this _______ day of ____________________, 19____.                      
                             _________________________________________           
                                          Petitioner                             
    Sworn and Subscribed on _________________________________________            
                             _________________________________________           
                             Notary Public for the State of Washington           
                             Residing at _____________________________           
                             My commission expires on ________________