DHMH 2A - Report as to Certification of Commitment - dhmh maryland 2025

1. Click ‘Get Form’ to open the DHMH 2A document in the editor.
2. Begin by entering your name and title (physician or psychologist) in the designated fields at the top of the form.
3. In the section for the individual's name, clearly input the full name of the patient being evaluated.
4. Provide the DSM diagnosis for the individual’s mental disorder in Axis I, ensuring accuracy for effective treatment planning.
5. Detail why inpatient care is necessary by filling out the corresponding field with specific reasons related to the patient's condition.
6. Indicate any potential danger posed by the patient to themselves or others, providing thorough explanations as required.
7. Document whether the patient is unable or unwilling to be voluntarily admitted, citing evidence in that section.
8. Complete information regarding less restrictive alternatives and confirm that none are available, ensuring clarity on this critical point.
9. If applicable, fill out details regarding AERS evaluation for patients aged 65 and older, including team member's name and evaluation date.
10. Finally, sign and print your name along with indicating the time before submitting or saving your completed form.

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