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Order For Mental Health Evaluation CM-11 - Maryland
|Order For Mental Health Evaluation Form. This is a Maryland form and can be used in Case Management Family Law Circuit Court Statewide .||
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* Plaintiff v. * * * Defendant * * * * * * * * IN THE CIRCUIT COURT FOR ________________________ Civil No.: * * * * * * ORDER FOR MENTAL HEALTH EVALUATION THE COURT HAVING DETERMINED that a psychological evaluation of a party or day of , by minor child is necessary, it is this County, Maryland, hereby the Circuit Court for ORDERED that Name of Mental Health Evaluator be appointed to conduct a mental health evaluation of the following person(s): ; and it is further ORDERED that the mental health evaluation shall include the following: [ [ ] ] a clinical assessment of the persons referenced above; and it is further a clinical assessment and any psychodiagnostic testing deemed appropriate by the evaluator; and it is further ORDERED that the evaluation is to be paid for in the following manner: ; and it is further ORDERED that upon completion of this evaluation a formal report will be submitted to the Court for review prior to final disposition of this case. JUDGE Recommended by: (Date) Page 1 of 2 CM 11 - Revised 9 March 2000 2001 © American LegalNet, Inc. NOTICE Communications between the mental health evaluator and the persons ordered to submit to a mental health evaluation are not confidential and shall not be privileged. All meetings with the mental health evaluator shall be considered conducted for the purposes of litigation and may be referred to or disclosed at trial or in documents prepared in conjunction with the pending court action. cc: Mental Health Evaluator Address City State Zip Page 2 of 2 CM 11 - Revised 9 March 2000 2001 © American LegalNet, Inc.