SOP 508.26-att-4: Involuntary Medication Rights of Offender

SOP 508.26
Attachment 4

8/8/23

1. You will have 24 hours after receiving this notification to decide if you wish to contest
the doctor's recommendation to accept medication.

2. If you continue to refuse medication, you have a right to go before a Due Process
Committee. This committee will hold a full and fair hearing to consider whether or not you
meet the criteria for involuntary medication. The Due Process Hearing Committee will be
composed of a deputy warden of care and treatment, a mental health staff member (not
currently involved with the MH treatment of the offender) and a medical staff member.

3. You have the right to represent yourself at the hearing. If you do not wish to represent
yourself at the hearing, you may request the assistance of an advocate. You may elect
to have a mental health counselor of the Georgia Department of Corrections serve as
your advocate. You may also seek representation from any attorney licensed in Georgia
at your expense. Your advocate or representative may assist you at the hearing.

4. You have the right to full disclosure of the evidence against you.

5. You or your advocate have the right to present any relevant evidence to the hearing
officer.

6. You have the right to call witnesses on your behalf as long as they are reasonably
available unless good cause exists not to allow. The hearing officer can decide to take
their testimony by telephone or in writing.

7. You have the right to question or cross-examine witnesses called at the hearing by the
Georgia Department of Corrections. The hearing officer, however, has discretion to
properly deny your request to confront and cross-examine particular witnesses if the
hearing officer believes that good cause exists not to allow.

8. You have the right not to have a hearing and to proceed with the psychiatric treatment,
which has been recommended for you.

Form No. M66-01-04 Page 1 of 2

Retention Schedule: Completed forms shall be given to the medical file (original - section 5), a copy shall be given to the offender and placed in
the offender’s mental health file (section 5). At the end of the offender’s need for mental health services and/or sentence, the mental health file
shall be placed within the offender’s health record and retained for 10 years.

SOP 508.26
Attachment 4

8/8/23

Acknowledgement of Notification

(Initial and circle any items which apply.)

A. I do hereby state that I have read or have had explained to me the decision of the need
for medication in my case.

B. I do hereby also state that I have read or have had explained to me all of my rights to a
hearing to contest the recommendation that I receive medication.

C. I (do) (do not) elect to have a counselor with the Georgia Department of Corrections
serve as my advocate.

D. I (do) (do not) elect to retain a private attorney at my own expense.

E. I (do) (do not) wish to attend the hearing.

____________________________________________________________________________
Signature of Counselor

____________________________________________________________________________
Offender's Signature and ID #

____________________________________________________________________________
Signature of Witness and Title

_______________________  ________________________
Date Time

Form No. M66-01-04 Page 2 of 2

Retention Schedule: Completed forms shall be given to the medical file (original - section 5), a copy shall be given to the offender and placed in
the offender’s mental health file (section 5). At the end of the offender’s need for mental health services and/or sentence, the mental health file
shall be placed within the offender’s health record and retained for 10 years.