DHMH 2A - Report as to Certification of Commitment - dhmh maryland 2026

1. Click ‘Get Form’ to open the DHMH 2A document in the editor.
2. Begin by entering your name and title in the designated fields at the top of the form. This identifies you as the certifying physician or psychologist.
3. In the section for the individual's name, clearly write the full name of the patient being evaluated.
4. Provide a detailed DSM diagnosis in the specified field, ensuring it reflects Axis I non-substance abuse as the primary focus of treatment.
5. Explain why inpatient care is necessary for the patient in the next section, detailing their condition and needs.
6. Indicate any potential danger posed by the patient to themselves or others, providing specific examples if applicable.
7. Document whether the patient is unable or unwilling to be voluntarily admitted, including evidence supporting this statement.
8. Confirm that no less restrictive alternatives are available for treatment, explaining why inpatient care is essential for safety and welfare.
9. If applicable, complete the section regarding AERS evaluation for patients aged 65 and older, including details about who conducted it and when.
10. Finally, sign and print your name along with indicating the time of completion at the bottom of the form.

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