Secure Treatment Order
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2ONTARIO
Court file number
(Name of Court)
Form 25B: Secure
SEAL
at
Treatment Order
Court office address
Applicant(s)
Full legal name & address for service — street &
Lawyer’s name & address — street & number,
number, municipality, postal code, telephone & fax
municipality, postal code, telephone & fax numbers
numbers and e-mail address (if any).
and e-mail address (if any).
Judge (print or type name)
Child
Lawyer’s name & address — street & number,
Full legal name of child:
municipality, postal code, telephone & fax numbers
and e-mail address (if any).
Date of order
Birth date (d, m, y):
Sex:
The court heard an application of
(name of person or persons)
The following persons were in court
(names of parties and lawyers in court)
The court received evidence and heard submissions on behalf of
(name or names)
THIS COURT ORDERS THAT:
(child’s full legal name)
be committed to the secure treatment program at
(name and address of program)
for a period of
days, beginning on
(date)
the commitment of
(child’s full legal name)
to the secure treatment program at
(name and address of program)
be extended for a period of
days, beginning on
(date)
this application for an order
of commitment
extending the commitment
of
(child’s full legal name)
to the secure treatment program at
(name and address of program)
be dismissed.
Other
(
;specify.)
FLR-25B-E (2005/09)
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