1348

LAWS OF MARYLAND

Ch. 236

At the time of my examination, the above named patient
showed the following symptoms:

Physical (Illness, Injury, Deformity) ......................

Mental (History and Mental Status)

I hereby certify that on .................., 19......,

I, a graduate of ................ Medical College and

licensed to practice in the State of Maryland, or I, duly
[certified] LICENSED to practice psychology under the
[Psychologists' Certification] MARYLAND PSYCHOLOGISTS Act
and listed in the National Register of Health Service
Providers in Psychology, personally examined the above named
patient and believe that he has a mental disorder and that
the disorder is of a character which, in my opinion,
requires that the patient be placed in a facility for the
treatment of the mentally disordered. I am not related by
blood or marriage to the patient, nor do I have any
financial interest in the facility in which it is proposed
to place the patient. I further certify that this
certificate is signed and made within one week of the
examination of the patient.

Signed: ....................                    Date: .................

(2)  No certificate shall be used for purposes of
admission if based on an examination made more than 30 days
prior to receipt of the application for admission by the
facility or the Veterans' Administration hospital.

(3)  No certificate shall be executed by any
physician or [certified] LICENSED psychologist, financially
interested, by reason of ownership or compensation, in any
proprietary facility in which it is proposed to admit the
person whose status is being certified, nor may such
physician or psychologist be related by blood or marriage to
either the prospective patient or the applicant.

22.

(a) As used in this subtitle, the following terms
shall have the meanings indicated unless a contrary meaning
is clearly intended from the context in which the term
appears.

(4)  "Mental disorder" means the behavioral and
other symptoms which to a lay petitioner initiating the
emergency admission process indicate a clear disturbance in
the mental functioning of another person, and to a physician
or [certified] LICENSED psychologist conducting an
examination indicate one or more of the mental disorders