§43A-5-305.

§43A-5-305.
   
   Any person desiring and needing psychiatric treatment in a state
   hospital for the mentally ill as a voluntary patient may present his
   written application to the judge of the district court of the county
   in which he resides, or of the county in which a state hospital for
   the mentally ill is located, which application may be in substantially
   the following form:
   
   IN THE COUNTY COURT OF _________________________ COUNTY, OKLAHOMA
   
   In the Matter of the
   
   Mental Health of No._____________
   
   _________________ on the Mental Health
   
   Patient Docket
   
   APPLICATION FOR VOLUNTARY ADMISSION TO MENTAL HOSPITAL
   
   I declare that my name is ____, that I am ____ years of age, and that
   I reside in ____ County, Oklahoma, my permanent residence address
   being as follows:
   
   ______________________________________________________________
   
   I have obtained medical advice concerning my condition, and I desire
   to be admitted to the ____ State Hospital at ____, Oklahoma, as a
   voluntary patient under the provisions of the Mental Hospital
   Voluntary Admission Procedures Act. I understand that if admitted to
   said hospital I may be detained in said hospital until the
   superintendent of said hospital concludes that it is proper for me to
   be released, not exceeding, however, a period of sixty days after I
   give written notification to the superintendent or his designee of my
   desire to leave the hospital.
   
   I declare that the names and addresses of my close relatives are as
   follows:
   
   Father: _______________________
   
   Mother: _______________________
   
   Spouse: _______________________
   
   Adult Children: _______________
   
   Other: ________________________
   
   Dated this ____ day of _____, 19__.
   
   ___________________
   
   (Signature)