16-c Designation of psychiatric examiners  


C.P.L. Article 730 FORM 16-c 12/88
DESIGNATION OF PSYCHIATRIC EXAMINERS
_______
COURT OF
_______
COUNTY OF
_________
__________
x
PEOPLE OF THE STATE OF NEW YORK,
 
DESIGNATION OF
 
PSYCHIATRIC
– against –
 
EXAMINERS
 
Docket No.
__
 
_______
 
Indictment No. __ Defendant. __________x
The undersigned, having been directed by order signed by Honorable __, (Judge) (Justice) of the __ Court of __ County, dated __, to examine the above named defendant pursuant to Article 730 of the Criminal Procedure Law, does hereby designate __, a qualified psychiatrist and __ (a qualified psychiatrist) (a qualified psychologist) for the purpose of conducting the examination of said defendant, each to make a separate report of said examination.
Dated:
______
 
Signature
Printed Name
□ Director of Community Mental
Health Services,
 
County
□ Director
 
Hospital