IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF TEXAS
[DIVISION] DIVISION

UNITED STATES OF AMERICA,	     §
§
§
V.	                                                                 §		NO. [CASE NUMBER]
§
[CLIENT]	                                                     §

MOTION FOR PSYCHIATRIC AND
PSYCHOLOGICAL EXAMINATION 

	COMES NOW Counsel for Defendant, and pursuant to Title 18, United States Code, §§ 4242 (d) and 4242, hereby files this its Motion for Psychiatric and/or Psychological Examination of Defendant, [CLIENT], and would state the following:
	Upon interview, Defendant appears to be suffering from a mental disease or defect or other mental condition bearing upon the issue of guilt.  This mental disease or defect possibly renders [CLIENT HIM/HER] mentally incompetent to the extent that [CLIENT HE/SHE] is possibly unable to understand the nature and consequences of the proceeding against [CLIENT HIM/HER] or unable to assist properly in [CLIENT HIS/HER] defense.
II.
	Counsel for Defendant requests the Court to order that the Defendant, pursuant to Title 18, United States Code, § 4241(d), be committed to the custody of the U.S. Medical Center for Federal Prisoners at Fort Worth, Texas and to order a psychiatric and psychological examination of the Defendant to be conducted at the United States Medical Center for Federal Prisoners located at Fort Worth, Texas, on the issue of determination of the Defendant's sanity at the time of the commission of the offense herein, and on the issue of any mental disease or defect or any other mental condition of the Defendant bearing on the issue of [CLIENT HIS/HER] guilt, and that the psychiatric and psychological reports be filed with the Court with copies provided to the counsel for the person examined and to the attorney for the government pursuant to the provisions of Title 18, United States Code, § 4247(c).
	WHEREFORE, the Counsel for Defendant prays that pursuant to Title 18, United States Code, §§ 4241, 4242, and 4247 this Court order that the Defendant, [CLIENT], be committed to the U.S. Medical Center for Federal Prisoners at Fort Worth, Texas to be examined, on the issues of determination of the Defendant's sanity at the time of the commission of the offense herein, and on the issue of any mental disease or defect or any other mental condition of the defendant bearing on the issue of [CLIENT HIS/HER] guilt; and that the examiners conducting such psychiatric and psychological examinations be ordered to prepare reports in accordance with Title 18, United States Code, § 4247(b), (c) and (e).

						Respectfully submitted,

						BY: __________________________
						Name
						State Bar No. [BAR NUMBER]
						Address
						City, State, Zip
						Telephone 
						Attorney for Defendant

CERTIFICATE OF SERVICE

	I, Philip Wischkaemper, certify that on the               day of [MONTH], [YEAR], a copy of the foregoing was hand-delivered to the United States Attorney's office at _____________________________.

						_________________________________________
						Attorney for Defendant

IN THE UNITED STATES DISTRICT COURT
FOR THE _______________ DISTRICT OF TEXAS
_________________  DIVISION

UNITED STATES OF AMERICA,	     §
§
§
V.	                                                                 §		NO. [CASE NUMBER]
§
[CLIENT]	                                                     §

ORDER FOR PRE-TRIAL PSYCHIATRIC
AND PSYCHOLOGICAL EXAMINATION 

	The Court, having considered the Defendant's Motion for Psychiatric and Psychological Examination of Defendant, [CLIENT], and the Court being fully advised in the premises,
	IT IS THEREFORE ORDERED pursuant to Title 18, United States Code, §§ 4241 and 4242, that Defendant, [CLIENT], be and is hereby committed to the custody of the U.S. Medical Center for Federal Prisoners at Fort Worth, Texas, whereby [CLIENT HE/SHE] may be examined pursuant to the provisions of Title 18, United States Code, § 4247(b).  The purposes of said examination are to determine (1) the competency of the Defendant to stand trial, pursuant to the provisions of Title 18, United States Code, § 4241; (2) whether the Defendant was insane at the time of the alleged offenses in accordance with the provisions of Title 18, United States Code, § 4242; and (3) whether the Defendant has a mental disease or defect or any other mental condition bearing upon the issue of guilt as set forth in Rule 12.2(b).

	IT IS FURTHER ORDERED that said examination shall be conducted at the U.S. Medical Center for Federal Prisoners at Fort Worth, Texas, unless that is impractical, and in that event said examination shall be conducted in a suitable facility closest to the Court.
	IT IS FURTHER ORDERED that said examination will be conducted pursuant to the time provision set forth in Title 18, United States Code, § 4247(b), and that upon completion  of said examination, the examiners will prepare and file with the court, with a copy to counsel for Defendant and the attorney for the Government, the written reports as described in Title 18, United States Code, § 4247(c).  Specifically, the report should include, among the other requirements set forth in Title 18, United States Code, §§ 4247 (b) (c), and (e), the examiners' opinion as to whether Defendant, [CLIENT], is suffering from a mental disease or defect rendering [CLIENT HIM/HER] mentally incompetent to the extent that [CLIENT HE/SHE] is unable to understand the nature and consequences of the proceedings against [CLIENT HIM/HER] or to assist properly in [CLIENT HIS/HER] defense, and further, whether in the opinion of the examiners, the Defendant, [CLIENT], was at the time of the commission of the acts constituting the offenses charged in the motion herein, as a result of a severe mental disease or defect, unable to appreciate the nature and quality or the wrongfulness of [CLIENT HIS/HER] acts, or whether the Defendant has a mental disease or defect or any other mental condition bearing upon the issue of guilt as set forth in Rule 12.2.  (Title 18, United States Code, § 17).
	IT IS FURTHER ORDERED that upon completion and filing of said reports with the Court, that the Defendant be returned to this Court for hearing pursuant to the provisions of law.
	IT IS FURTHER ORDERED that Defendant's counsel is required to provide any and all medical reports presently in [CLIENT HIS/HER] possession or that come in [CLIENT HIS/HER] possession to the United States Medical center for Federal Prisoners, and to the Assistant United States Attorney in Lubbock, Texas, concerning the medical condition of the Defendant.
	ENTERED this the _______ day of _______________, 20_____.

						___________________________________________
						UNITED STATES JUDGE