This form may be used to request an independent mental examination of a proposed ward under Texas Estates Code section 1101.103 or 1101.104. For an examination of a proposed ward whose alleged incapacity is intellectual disability, section 1101.104 requires that the physician or psychologist appointed be certified by the Texas Department of Aging and Disability Services. Tex. Est. Code § 1101.104.
[Caption. See § 3 of the Introduction in this manual.]
Motion for Independent Mental Examination
[Name of movant], Movant, makes this Motion for Independent Mental Examination and in support shows the Court the following:
1.Movant believes it is in the best interests of [name of proposed ward], Proposed Ward, to be evaluated by an independent [psychiatrist/psychologist/physician] in this proceeding.
2.Movant believes it would be in Proposed Ward’s best interests, pursuant to section section [1101.103/1101.104] of the Texas Estates Code, for the Court to order a complete independent mental examination of Proposed Ward to be conducted by a court-designated, board-certified [include if applicable: geriatric/pediatric] [psychiatrist/psychologist/physician] for the purpose of [describe purpose of examination, e.g., determining Proposed Ward’s present mental state and assessing [his/her] care and rehabilitation needs].
3.Based on the facts, there is good cause shown for a compulsory independent mental examination of Proposed Ward.
4.Movant therefore requests that the Court designate the time, place, manner, conditions, and scope of the examination to be conducted by the [psychiatrist/psychologist/physician] named by the Court to make the examination of Proposed Ward. Movant also asks this Court to order all parties to supply the [psychiatrist/psychologist/physician] with all of Proposed Ward’s medical records from [date] to the present in their possession or that of their attorneys. [Include if applicable: [Name of caretaker] should also be ordered to turn over [his/her] daily log of medications.] It is further requested that the report of the examining [psychiatrist/psychologist/physician] be provided to the Court and all attorneys of record.
5.Movant requests that the cost of the examination be paid by Proposed Ward’s estate as it is beneficial to Proposed Ward to have the facts of [his/her] mental status determined.
6.Movant requests that Proposed Ward be examined with no one else present other than the court-appointed [psychiatrist/psychologist/physician] and his or her staff and medical advisors and that no one communicate with the [psychiatrist/psychologist/physician] before the issuance of his or her report, other than to provide the medical records by letter with copies to all attorneys of record.
Movant prays that the Court order that Proposed Ward be examined by a board-certified [include if applicable: geriatric/pediatric] [psychiatrist/psychologist/physician] designated by this Court for the purpose of undergoing an independent mental examination pursuant to section [1101.103/1101.104] of the Texas Estates Code to determine [his/her] mental status; that the Court order the medical records be turned over; that a hearing be held on the motion; that no one be present at the examination except Proposed Ward, the [psychiatrist/psychologist/physician], and [his/her] staff and medical advisors; that the Court order the examination to be paid by [name]; and for all other relief to which Movant may be entitled.
Respectfully submitted,
[Name]
Attorney for Movant
State Bar No.:
[Email address]
[Address]
[Telephone]
[Telecopier]
Certificate of Service
I certify that a true copy of this [title of document] was served in accordance with rule 21a of the Texas Rules of Civil Procedure.
SIGNED on ________________________________.
[Name of attorney]