PART D — DETAILS OF ANY EXTENSION GRANTED
This urgent authorisation has been extended:
for a further period of: DAYS
Enter number of days in the box above ×
The period speciﬁ ed must not exceed seven days
Unless the request for a standard authorisation is disposed of before then, this urgent authorisation will
at the end of the day on:
Enter new date on which it will expire above ×
PART E — GIVING NOTICE OF THE EXTENSION
The supervisory body will give the managing authority a copy of this form as soon as practicable.
(on behalf of the supervisory body)
NOTE TO THE MANAGING AUTHORITY OF THE HOSPITAL OR CARE HOME
Varying the original urgent authorisation
If this notice extends the urgent authorisation, the managing authority should vary the original urgent
authorisation by entering details of the extension granted in Part H of Form 1.
Providing rights information
The managing authority must take all practicable steps to ensure that the person who is deprived of liberty
(a) the effect of any extension of the urgent authorisation
(b) their right to make an application to the Court of Protection, challenging the urgent authorisation.
These steps must be taken as soon as is practicable after this extension is given. The required information
must be given both orally and in writing.
GFSB-Liberty Form 3.indd 3 19/2/09 13:20:56
click to sign
click to edit