RULE 6.4                                               
            PETITION FOR ONE HUNDRED EIGHTY-DAY                                  
                   INVOLUNTARY TREATMENT                                         
                                                                                 
    The petition for 180-day involuntary treatment shall contain the             
following:                                                                       
    (a) The name and address of the person filing the petition and the           
statement that the petitioner is the superintendent or professional person       
in charge of the facility in which the person who is alleged, as a result        
of mental disorder, to present a likelihood of serious harm to others, is        
detained, or in the event that the defendant has received involuntary            
treatment but has not been committed to a treatment facility or has been         
conditionally released from such a facility, a statement that the                
petitioner is the county mental health professional of (name) County.            
    (b) The name and address of the person alleged, as a result of a mental      
disorder, to present a likelihood of serious harm to others because such         
person (1) during his/her current period of court ordered treatment has          
threatened, attempted or actually inflicted physical harm on another or          
substantial damage upon the property of another, or (2) was taken into           
custody as a result of conduct in which he/she attempted or inflicted            
serious physical harm upon the person of another and continues to present,       
as a result of mental disorder, a likelihood of serious harm to others, or       
(3) is in custody pursuant to RCW 71.05.280(3) (acts constituting a felony)      
and as a result of mental disorder presents a substantial likelihood of          
repeating similar acts, or (4) continues to be gravely disabled. Such            
person shall be denominated the respondent.                                      
    (c) The name of the court ordering involuntary treatment for which the       
respondent is presently detained, and the date on which such order was           
entered.                                                                         
    (d) A summary of the facts supporting the allegations of the petition.       
    (e) 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 180-day treatment      
on the issue of whether the person alleged, as a result of mental disorder,      
to present a likelihood of serious harm to others, shall be detained for         
involuntary treatment for a period not to exceed 180 days.                       
    (f) A statement that a form of treatment less restrictive than               
involuntary detention is not in the best interest of the respondent or           
others.                                                                          
    (g) The petition shall be in substantially the following form:               
                                                                                 
                SUPERIOR COURT OF WASHINGTON                                     
                FOR (_______________) COUNTY                                     
                                                                                 
In re the Detention of:   )               No. __________                         
                          )                                                      
                          )               PETITION FOR ONE HUNDRED               
                          )               EIGHTY-DAY INVOLUNTARY                 
                          )                      TREATMENT                       
                          )                                                      
     Respondent.          )               RCW __________                         
                                                                                 
    (Petitioner), the superintendent or professional person in charge 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 _____.                                                                       
    (Respondent) ___ has threatened, attempted or actually inflicted harm        
on another person, or substantial damage upon the property of another            
during respondent's current period of court ordered treatment and as a           
result of mental disorder presents a likelihood of serious harm to others,       
or ___ was taken into custody as a result of conduct in which respondent         
attempted or inflicted serious physical harm upon the person of another and      
continues to present as a result of mental disorder a likelihood of serious      
harm to others, or ___ is in custody pursuant to RCW 71.05.280(3) (acts          
constituting a felony) and as a result of mental disorder presents a             
substantial likelihood of repeating similar acts, or ___ continues to be         
gravely disabled.                                                                
    The facts upon which the allegations of this petition are based              
are as follows: ______________________________________________________           
______________________________________________________________________           
______________________________________________________________________           
    A form of treatment less restrictive than involuntary detention is not       
in the best interest of the respondent or others.                                
    The petitioner requests that a hearing be held to determine whether          
(respondent) shall be detained for involuntary treatment for a period not        
to exceed 180 days.                                                              
    Dated this _______ day of ____________________, 19____.                      
                             _________________________________________           
                                            Petitioner                           
    Sworn and Subscribed on _________________________________________            
                             _________________________________________           
                             Notary Public for the State of Washington           
                             Residing at _____________________________           
                             My commission expires on ________________