California DHCS-1808 Section 5250 Form: Copies, Hearing, Extension

The California DHCS-1808 form is the one-page certification a psychiatric facility uses to convert a 72-hour emergency hold into up to 14 additional days of involuntary treatment under Welfare and Institutions Code Section 5250. Completing it correctly means documenting the clinical basis for the hold, getting the right signatures, personally delivering a copy to the patient, and distributing the remaining copies to the Superior Court, the patient’s attorney, the Public Defender, the District Attorney, and the treatment facility — all on the same day the patient is notified.

When the Form Applies

The DHCS-1808 is only used after someone has already been detained under a WIC 5150 hold, the initial 72-hour evaluation period for a person who, due to a mental health disorder, is a danger to self, a danger to others, or gravely disabled.¹ If the treatment team concludes within that 72 hours that the person still meets the criteria and won’t accept voluntary care, the facility can certify up to 14 more days. The DHCS-1808 is the document that records that decision.²

Three conditions must all be true before signing:

The evaluating facility’s professional staff has found that the person, because of a mental health disorder or chronic alcoholism, remains a danger to others, a danger to self, or gravely disabled.
The intensive-treatment facility is county-designated and agrees to admit the person.
The person has been told they need treatment and has been unwilling or unable to accept it voluntarily.²

One important limit on the grave disability ground: a person is not gravely disabled if family, friends, or others are both willing and able to help with food, clothing, or shelter. Those supporters must put their willingness in writing. The statute specifically avoids forcing anyone to publicly state they are unwilling to help.²

Filling Out Each Section

The current DHCS-1808 (revised May 2024) is a single-page PDF available from the Department of Health Care Services website.³ Every field is short, but every field matters, because this document is the legal basis for continued detention.

Top of the Form

Check whether the certification is for a 14-day hold under Section 5250 or a 30-day hold under Section 5270.15. For an initial certification following a 5150, this is the 14-day box. Then enter the county where the evaluation agency operates.

Patient Identification

The patient block asks for five items: full legal name, home address (not the facility address), marital status, date of birth, and sex. The form does not ask for a Social Security number, physical description, or facility provider number.

Criteria Boxes

Check all that apply from three options: danger to others as a result of a mental health disorder, danger to self as a result of a mental health disorder, or gravely disabled as defined in WIC Section 5008(h). Grave disability can be based on a mental health disorder, a severe substance use disorder, or both occurring together.³

Narrative of Supporting Facts

This is the clinically and legally most important field. Describe the specific facts supporting the opinion that the patient meets the checked criteria: observed behaviors, statements the patient made, actions taken or attempted, inability to care for self, or other concrete evidence. A hearing officer will weigh this narrative to decide whether probable cause exists. A generic statement like “patient is a danger” does not meet that standard.

Voluntary Treatment Refusal

A separate field requires a statement that the person was informed of the evaluation, advised of the need for treatment, and was either unwilling or unable to accept treatment voluntarily or accept a referral to listed services. Name the specific services that were offered and refused.

Certification and Signatures

The certification block at the bottom records the start date of intensive treatment (day, month, year) and the name of the treating facility. Two authorized professionals sign and date here. A third signature line is for the staff member who physically delivers the notice to the patient.

Who Can Sign

WIC Section 5251 is strict about who is allowed on the two certification signature lines. Getting this wrong can invalidate the hold.

The first signature must come from the professional person in charge of the evaluating agency or facility, or that person’s designee. A designee must be either a physician or a licensed psychologist with a doctoral degree and at least five years of postgraduate experience diagnosing and treating mental disorders.⁴

The second signature must come from a physician or psychologist who participated in the evaluation. The statute says the physician should be a board-certified psychiatrist “if possible,” and the psychologist must be licensed with at least five years of postgraduate experience.⁴

There is a fallback. If the professional person in charge (or the designee) is also the physician who performed the evaluation, or is a psychologist, the second signer may be another physician or psychologist. If neither is available, a licensed clinical social worker or registered nurse who participated in the evaluation may sign as the second professional. The law treats that option as a last resort, not a default.⁴

Where Each Copy Goes

The bottom of the DHCS-1808 specifies the distribution exactly:³

Original: Superior Court.
Copy 1: The person certified, delivered personally by hand.
Copy 2: The person’s attorney.
Copy 3: The Public Defender.
Copy 4: The District Attorney.
Copy 5: The intensive treatment facility.

Personal, in-hand delivery to the patient is not optional. The staff member who hands the patient their copy signs and dates the delivery section of the form, confirming they delivered the notice and informed the patient of the hearing and the right to legal assistance. The court must be notified of the certification on the same day the patient is notified.

What You Must Tell the Patient at Delivery

At the moment of delivery, the staff member must verbally inform the patient of two things, matching the delivery statement printed on the form itself:

A certification review hearing will be held within four days unless the patient instead requests judicial review.
An attorney or advocate will visit to help prepare for the hearing, answer questions about the commitment, or provide other assistance.³

Timing matters. Delays in delivery or court notification can create procedural grounds for a challenge at the hearing.

The Hearing the Form Triggers

Every 5250 certification sets off a mandatory certification review hearing within four days, unless the patient files for judicial review through a writ of habeas corpus instead. The patient or attorney can request a postponement; the facility cannot delay the hearing on its own.⁵

A court-appointed commissioner, referee, or certification review hearing officer presides.⁶ The facility carries the burden of showing probable cause that the patient still meets the statutory criteria. The narrative section of the DHCS-1808 is the central piece of evidence, which is why vague or boilerplate descriptions are a real problem. If the hearing officer finds the evidence insufficient, the patient is released from involuntary status.

An attorney or the county patients’ rights advocate must meet with the patient before the hearing. If the patient files a habeas writ before the certification review hearing occurs, the writ proceeding replaces the hearing; the patient does not get both.⁵

Using the Same Form for a 30-Day Extension

The DHCS-1808 also covers a second certification of up to 30 additional days under WIC Section 5270.15, after a patient has completed the initial 14 days of intensive treatment. The scope of the 30-day certification is narrower than the 14-day: it is available only when the patient remains gravely disabled, not for danger to self or danger to others, and the patient continues to be unwilling or unable to accept voluntary treatment.³ A fresh DHCS-1808 is required, with the 30-day box checked, new narrative facts supporting continued grave disability, and new signatures that meet the same professional requirements as the original.

Firearms Reporting Is a Separate Form

Facilities have an independent duty under WIC Section 8105 to report certain involuntary holds to the California Department of Justice so the state can identify people prohibited from possessing firearms under WIC Section 8100.⁷ A DOJ information bulletin directs facilities to use the Mental Health Facilities Report of Firearm Prohibition (Form 4009A) for this purpose.⁸ That is a different form with a different purpose from the DHCS-1808. Treat the two as parallel tasks: the DHCS-1808 goes to courts and counsel to document the clinical certification, and Form 4009A goes to the DOJ to update firearms prohibition records.

1
California Legislative Information. WIC Code 5150 – Detention of Persons with a Mental Health Condition for Evaluation and Treatment
2
California Legislative Information. California Welfare and Institutions Code 5250 – Certification for Intensive Treatment
3
Department of Health Care Services. DHCS 1808 – Notice of Certification for Intensive Treatment
4
Justia Law. California Welfare and Institutions Code Article 4 – Certification for Intensive Treatment
5
California Legislative Information. California Welfare and Institutions Code 5256 – Certification Review Hearing
6
California Legislative Information. California Welfare and Institutions Code 5256.1 – Certification Review Hearing Conducted by Commissioner, Referee, or Officer
7
California Legislative Information. California Welfare and Institutions Code 8105
8
California Department of Justice. Mental Health Reporting Requirements Information Bulletin