Attachment #5.pdf

This is Form 909B, a waiver evaluation form issued by the South Carolina Department of Juvenile Justice under Executive Director Freddie B. Pough, designed for use by County Case Managers conducting interviews with juveniles subject to court-ordered psychological evaluations regarding potential transfer to General Sessions Court (adult court). The form documents a juvenile's informed consent to participate in psychological evaluation services when the Family Court has issued a State v. Hitopoulus protective order. The evaluation process is initiated by court order and is intended to assist the court in determining whether a juvenile's case should be transferred to adult court jurisdiction and whether the juvenile should be treated as an adult for purposes of criminal prosecution. The form requires completion prior to any psychological evaluation interview and includes signature lines for the juvenile, parent or guardian, attorney, and witnesses, along with fields for the juvenile's full name, date of birth, date, time, and witness information.

The form establishes critical protections for the juvenile by documenting that any oral or written communications made to the psychologist during the evaluation, related to the juvenile's charges, are protected from use as evidence in any court proceeding except for the waiver hearing itself. The juvenile must acknowledge understanding of these protections and confirm voluntary participation in the evaluation without promises, threats, inducements, pressure, or coercion. The form includes blank text fields for additional documentation or notes. This document serves as the procedural mechanism for implementing psychological evaluation services as part of South Carolina's juvenile justice system's waiver determination process, ensuring compliance with state legal protections while facilitating the court's assessment of appropriate jurisdiction and culpability determinations for juveniles facing potential adult prosecution.