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Order For Substance Abuse Assessment CM-15 - Maryland
| Order For Substance Abuse Assessment 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 SUBSTANCE ABUSE ASSESSMENT IT IS this Court for ORDERED that Name of Person to be Tested day of County, Maryland, hereby , 2 by the Circuit shall submit to a substance abuse assessment, to be conducted by: Substance Abuse Testing Facility Address City Telephone Number State Zip Code ; and it is further ORDERED that the substance abuse assessment shall include the following services: [] Rapid Substance Abuse Assessment. The person referred to above shall submit to psychometric testing and a clinical interview. No urinalysis will be conducted. The testing facility shall submit the results of the rapid substance abuse assessment in writing to the court; and it is further Urinalysis Screening Only. The person referred to above shall appear at the offices of the substance abuse facility to provide a sample for urinalysis. The testing facility shall report the results of that urinalysis in writing to the Court; and it is further In-depth Substance Abuse Assessment. The person referred to above shall submit to psychometric testing and a clinical interview. They shall also be required to provide a sample for urinalysis. The testing facility shall report the results of the American LegalNet, Inc. www.FormsWorkflow.com [] [] Page 1 of 2 CM 15 - Revised 9 March 2000 substance abuse assessment and urinalysis results in writing to the court; and it is further ORDERED, that the fee for the substance abuse assessment shall be paid for in the . following manner: JUDGE Recommended by: (Date) NOTICE This substance abuse assessment has been ordered solely for the purposes of litigation and does not establish a therapeutic relationship between the testing facility and the subject of the assessment. The results of the testing are not confidential and may be disclosed at trial or in anticipation of trial. cc: Testing Facility Address City Telephone State Zip American LegalNet, Inc. www.FormsWorkflow.com Page 2 of 2 CM 15 - Revised 9 March 2000
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