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Deprivation of liberty application form - For urgent consideration

Document Cited authorities 2 Cited in Related
Published date21 March 2018
COP
DLA
07.15
Court of Protection
Deprivation of liberty
Application form
Case no.
Date of application
Date of issue
For urgent consideration
This form should only be used for applications to vary or terminate a standard or urgent
authorisation made by a supervisory body under Schedule A1 of the Mental Capacity Act 2005.
Full name of person to whom the application relates including their date of birth
(this is the name of the person who lacks, or is alleged to lack, capacity)
Date of birth / /
Date of urgent/
standard authorisation / / Date of eective detention / /
Section 1 – Contact details
Applicant
Name
Address
Postcode
Telephone no.
Mobile no.
Email
What is the applicant’s relationship to the
relevant person? (This is the person that the
application is about)
Applicant’s solicitor or representatives
Name
Address
Postcode
Telephone no.
Mobile no.
Fax no.
1 © Crown copyright 2015
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