Recommendation, Certification, and Order for Medical, Surgical, Dental, or Other Remedial Care
Alameda Superior Court · Frequently Used Forms
Verified current as of September 16, 2026
Used in juvenile dependency or delinquency cases for a physician or dentist to recommend medical, surgical, dental, or psychiatric treatment for a minor, and for a social worker or probation officer to certify related facts so a judge can order the care.
This form must be printed and filled by hand, or opened in Adobe Acrobat.