Attachment #4.doc

This is a judicial form from the South Carolina Department of Juvenile Justice used to document informed consent and understanding of protective court orders prior to conducting psychological evaluations for General Sessions Court waiver determinations. The form is completed by an evaluating psychologist before conducting an evaluation to assist the Family Court in determining whether a juvenile case should be transferred to adult court and whether the juvenile should be prosecuted as an adult. The document establishes that juveniles have been informed of State v. Hitopoulus protections, which restrict the use of oral or written communications made during the evaluation as evidence in criminal proceedings outside of the waiver hearing itself. The form requires signatures from the juvenile, parent or guardian, attorney, and witnesses to confirm understanding and voluntary participation in the evaluation process.

The form serves as a critical protection mechanism within South Carolina's juvenile justice system, ensuring compliance with established case law regarding confidentiality and admissibility of statements made during court-ordered psychological evaluations. By requiring documented acknowledgment that the juvenile understands the scope of the evaluation's purpose, the limitations on use of their statements, and their right to consult counsel, the form establishes a clear record of informed consent. The protective order detailed in the form is essential for maintaining the integrity of the waiver evaluation process while safeguarding juveniles' constitutional rights, as it prevents prosecutors from using statements made during these evaluations against juveniles in subsequent criminal proceedings except in the specific context of the waiver hearing itself.