Okla. Stat. tit. 43A, § 43A-11-110

incapacity – Conflicting instructions – Transfer when unable to

comply with directive.

A. The attending physician or psychologist shall continue to

obtain the declarant’s informed consent to all mental health

treatment decisions when the declarant is capable of providing

informed consent or refusal.

B. A declarant appearing to require mental health treatment

shall be examined by two persons, who shall be physicians or

psychologists. If after the examination the declarant is determined

to be incapable and is in need of mental health treatment, a written

certification, substantially in the form provided by subsection E of

this section, of the declarant’s condition shall be made a part of

the declarant’s medical record.

C. The attending physician or psychologist is authorized to act

in accordance with an operative advance directive for mental health

treatment when the declarant has been determined to be incapable and

mental health treatment is necessary. Except as otherwise provided

by this act with regard to conflicting instructions in an advance

directive for mental health treatment:

1. An attending physician or psychologist and any other

physician or psychologist under the attending physician’s or

psychologist’s direction or control, having possession of the

declaration of the consumer or having knowledge that the declaration

is part of the medical record of the consumer, shall follow as

closely as possible the terms of the declaration.

2. An attending physician or psychologist and any other

physician or psychologist under the attending physician’s direction

or control, having possession of the appointment of the consumer of

an attorney-in-fact or having knowledge of the appointment of an

attorney-in-fact, shall follow as closely as possible the

instruction of the attorney-in-fact.

D. An attending physician or psychologist who is unable to

comply with the terms of the declaration of the consumer shall make

the necessary arrangements to transfer the patient and the

appropriate medical records without delay to another physician or

psychologist.

1. A physician or psychologist who transfers the consumer

without unreasonable delay, or who makes a good faith attempt to do

so, shall not be subject to criminal prosecution or civil liability,

and shall not be found to have committed an act of unprofessional

conduct for refusal to comply with the terms of the declaration.

Transfer under these circumstances shall not constitute abandonment.

Oklahoma Statutes - Title 43A. Mental Health Page 244

2. The failure of an attending physician or psychologist to

transfer in accordance with this subsection shall constitute

professional misconduct.

E. The following certification of the examination of a

declarant determining whether the declarant is in need of mental

health treatment and whether the declarant is or is not incapable

may be utilized by examiners:

EXAMINER’S CERTIFICATION

We, the undersigned, have made an examination of

_______________, and do hereby certify that we made a careful

personal examination of the actual condition of the person and on

such examination we find that _____________________:

1. (Is) (Is not) in need of mental health treatment; and

2. (Is) (Is not) incapable to participate in decisions about

(her) (his) mental health treatment.

The facts and circumstances on which we base our opinions are

stated in the following report of symptoms and history of case,

which is hereby made a part hereof.

According to the advance directive for mental health treatment,

(name of consumer)_________________________________________, wishes

to receive mental health treatment in accordance with the

preferences and instructions stated in the advance directive for

mental health treatment.

We are duly licensed to practice in the State of Oklahoma, are

not related to _______________ by blood or marriage, and have no

interest in her/his estate.
tal health treatment,

(name of consumer)_________________________________________, wishes

to receive mental health treatment in accordance with the

preferences and instructions stated in the advance directive for

mental health treatment.

We are duly licensed to practice in the State of Oklahoma, are

not related to _______________ by blood or marriage, and have no

interest in her/his estate.

Witness our hands this ____________ day of _____________, 20__

___________________, M.D., D.O., Ph.D., Other

___________________, M.D., D.O., Ph.D., Other

Subscribed and sworn to before me this _______________________

day of ________________, 20__

__________________________________________

Notary Public

REPORT OF SYMPTOMS AND HISTORY OF

CASE BY EXAMINERS

1. GENERAL

Complete name ________________________________________________

Place of residence ___________________________________________

Sex _______________ Color ________________

Age _______________

Date of Birth ________________________________________________

2. STATEMENT OF FACTS AND CIRCUMSTANCES

Our determination that the declarant (is) (is not) in need for

mental health treatment is based on the following:

________________________________________________________

__________________________________________________________________

Oklahoma Statutes - Title 43A. Mental Health Page 245

Our determination that the declarant (is) (is not) incapable of

participating in mental health treatment decisions is based on the

following:________________________________________________________

__________________________________________________________________

3. NAME AND RELATIONSHIPS OF FAMILY MEMBERS/OTHERS TO BE NOTIFIED

Other data ___________________________________________________

Dated at _____________, Oklahoma, this __________ day of

___________________, 20__

_____________, M.D., D.O., Ph.D., Other

_______________________________________

Address

_____________, M.D., D.O., Ph.D., Other

_______________________________________

Address