ROBERT L. EHRLICH, JR., Governor                             Ch. 315

(i) Be signed and verified by the petitioner;
(ii) State the petitioner's:

1.       Name;

2.       Address; and

3.       Home and work telephone numbers;
(iii) State the emergency evaluee's:

1.       Name; and

2.       Description;

(iv) State the following information, if available:

1.       The address of the emergency evaluee; and

2.       The name and address of the spouse or a child, parent, or
other relative of the emergency evaluee or any other individual who is interested in
the emergency evaluee;

(V) IF THE INDIVIDUAL WHO MAKES THE PETITION FOR
EMERGENCY EVALUATION IS AN INDIVIDUAL AUTHORIZED TO DO SO UNDER
SUBSECTION (B)(1)(I) OF THIS SECTION, CONTAIN THE LICENSE NUMBER OF THE
INDIVIDUAL;

(v) (VI) Contain a description of the behavior and statements of
the emergency evaluee or any other information that led the petitioner to believe that
the emergency evaluee has a mental disorder and that the individual presents a
danger to the life or safety of the individual or of others; and

(vi) (VII) Contain any other facts that support the need for an
emergency evaluation.

(2) The petition form shall contain a notice that the petitioner:

(i) May be required to appear before a court; and

(ii) Makes the statements under penalties of perjury.

(d) (1) A petitioner who is a physician, psychologist, clinical social worker,
licensed clinical professional counselor, CLINICAL NURSE SPECIALIST IN
PSYCHIATRIC AND MENTAL HEALTH NURSING, PSYCHIATRIC NURSE PRACTITIONER,
health officer, or designee of a health officer shall give the petition to a peace officer.

(2) The peace officer shall explain to the petitioner:

(i) The serious nature of the petition; and

(ii) The meaning and content of the petition.

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