Petition for Conditional Release (Circuit Court)

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					DEPARTMENT OF HEALTH SERVICES                                                                                STATE OF WISCONSIN
Division of Mental Health and Substance Abuse Services                                                ss.971.17(4) Wisconsin Statutes
F-25393 (07/2008)

                                                        CIRCUIT COURT
STATE OF WISCONSIN                                                                                                       COUNTY

                 STATE OF WISCONSIN                                                      PETITION FOR
                                                                                      CONDITIONAL RELEASE
                           Plaintiff

                              vs

                                                                                           Court Case Number
                          Defendant

                                                                                         Client Institution Number




Date the defendant was committed by this court:




Date of last conditional release hearing:




Date (if any) when defendant was previously placed on conditional release:




Date when conditional release was revoked:




The Petitioner requests that the court schedule a hearing on this conditional release petition and that conditional release be
granted, based upon the court’s satisfaction that this defendant would not pose a significant risk of bodily harm to self or others or
cause serious property damage, if released under specific conditions.




                                                      SIGNATURE – Petitioner




                                            Title or Relationship of Petitioner to Defendant




                                                                Dated


                                   DISTRIBUTE COPIES TO District Attorney, Defense Attorney

				
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posted:10/1/2012
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