Informant Report for Jennifer L. Semple, dated February 19, 1969.
The above informant report was used to commit Jennifer (against her will) to the Cherokee Mental Health Institute.
Note that Harley Semple's (the author's grandfather) name has been scratched out and Opal Casey's added; Opal Casey was the police matron at the Sioux City, Iowa, police station.
The author was able to request and receive copies of her court and hospital records.
A text copy of this record appears in Memoir Madness: Driven to Involuntary Commitment.
To protect the current residents of Jennifer L. Semple's childhood home, her personal address and phone number have been removed from this photograph.