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Download Informacion personal Motibonan pa curatela
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PETICION PA CURATELA cu INGRESO/TRATAMENTO OBLIGATORIO Fecha:____________________, Aruba N.B. Por fabor lesa e formulario aki cuidadosamente y despues jen’e completamente. Informacion personal Nomber di persona en cuestion: ______________________________________________________________________ Nomber di peticionario: ______________________________________________________________________ Relacion entre peticionario y persona en cuestion: ______________________________________________________________________ Adres di peticionario: ______________________________________________________________________ Number di telefon di peticionario: ______________________________________________________________________ E-mailadres di peticionario: ______________________________________________________________________ Firma di peticionario: ______________________________________________________________________ Motibonan pa curatela Marca loke ta di aplicacion y agrega informacion (si ta necesario) ADICCION □ E persona en cuestion ta adicto na ____________________________y _________________________. E ta haci uso ______biaha pa dia/siman di_______________________, y ___ biaha pa dia/siman di ___________________________. □ Pa motibo di su adiccion e persona en cuestion no por zorg pa su mes. o o o E ta slenter riba caya E no ta laba su mes E no ta come o E no ta traha ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ □ Pa motibo di su adiccion e persona en cuestion repetidamente ta trese conflicto riba caya. E ta o molestia hende riba caya o cana rond sunu o cana burachi riba caya o cana riba caya bou di influencia di droga o haci desordo o (haci) pleita o kibra propiedad di otro hende o drenta propiedad di hende pa horta __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ □ Pa motibo di su addicion e persona en cuestion ta un peliger pa su mes of otro hende. E ta o menasa hende o maltrata hende o ta destrui propiedad di hende o bende droga __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ PROBLEMA DI TRASTORNO/DEFICIENCIA MENTAL □ E persona en cuestion tin un problema mental. E problema ta yama ___________________________________ _____________________________________________________________________________ d E problema aki a wordo constata ariba (fecha) door di dr._______________________________ ________ ______________________________________________(nomber di dokter).Pa motibo di e problema aki, e persona en cuestion no por regla su mesun asuntonan. Esei ta wordo constata a base di lo siguiente: __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ GASTAMENTO DI PLACA □ E persona en cuestion ta gasta su placa. Esaki ta wordo constata a base di lo siguiente: __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ IMPORTANTE - INFORMACION ADICIONAL E juez ta dicidi of bo peticion ta wordo aproba. Bo peticion por wordo nenga. Curatela ta un medida hopi serio. Un persona cu a wordo poni bou curatela no por tuma decisionan importante pa su mes. Admision y tratamento obligatorio ta medidanan mas serio ainda. E persona encuestion ta wordo deteni na Centro di Motivacion pa un anja y e anja aki por wordo prolonga. __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ 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