Fill Out Your Maryland Admission Template

When filling out the Maryland Admission form, it is important to follow certain guidelines to ensure the process goes smoothly. Here are four things to do and not to do:

• Do provide accurate personal information. Ensure that your name, address, and contact details are correct. This information is crucial for processing your application.
• Do understand the requirements. Familiarize yourself with the provisions of Health-General Article, §10-609 to know what is expected in your application.
• Do seek assistance if needed. If you have questions about the form or the process, don’t hesitate to ask for help from a trusted individual or a professional.
• Do keep a copy of your application. Retaining a copy can be helpful for your records and for any future reference.

• Don't leave sections blank. Ensure that all required fields are filled out completely. Incomplete forms may delay the admission process.
• Don't rush through the application. Take your time to read each section carefully. Mistakes can lead to complications.
• Don't forget to sign the form. Your signature is necessary to validate the application and indicate your consent.
• Don't ignore the endorsement requirement. Ensure that a licensed physician or psychologist reviews and endorses your application as required.

Here are four common misconceptions about the Maryland Admission form:

• Misconception 1: The form can be filled out by anyone.

The application for voluntary admission must be completed by the individual seeking admission, provided they are 16 years old or older. It is not valid if filled out by someone else.

• Misconception 2: Admission is guaranteed once the form is submitted.

Submitting the form does not guarantee admission. The facility will evaluate whether the individual meets specific criteria related to their mental health status.

• Misconception 3: Individuals can be held against their will after applying.

Individuals who apply for voluntary admission can leave the facility at any time, unless their status changes to involuntary admission.

• Misconception 4: Minors have the same admission process as adults.

Minors must have their application submitted by a parent or guardian. Additionally, they cannot be held for more than three days after a request for release, unless their status changes.

Filling out the Maryland Admission form requires careful attention to detail. Here are some key takeaways to help you through the process:

• Eligibility: You must be at least 16 years old to apply for voluntary admission to a facility.
• Complete Information: Ensure that all personal information, including your name, address, and date of birth, is accurately filled out.
• Physician's Endorsement: A licensed physician or psychologist must examine you and provide their endorsement on the form, confirming your mental health status.
• Understanding of Treatment: You need to demonstrate that you understand the nature of your request for treatment and can give ongoing consent for your stay.
• Release Process: If you wish to leave, you can request your release. If you are admitted voluntarily, you cannot be held for more than three days after your request, unless your status changes to involuntary admission.

Taking these points into account can make the admission process smoother and more straightforward. Always remember to ask for help if you need it.

1. Incomplete Personal Information: Failing to provide complete personal details such as name, address, and date of birth can delay the admission process. Ensure all fields are filled out accurately.

2. Missing Signatures: The application requires both the applicant's and the physician's or psychologist's signatures. Omitting either can result in rejection of the application.

3. Incorrect Facility Name: Applicants often forget to specify the name of the facility they wish to be admitted to. Double-check to ensure the correct facility is listed.

4. Failure to Understand Admission Criteria: Not being aware of the specific criteria for voluntary admission can lead to misunderstandings. Review the requirements to ensure eligibility.

5. Ignoring Physician’s Endorsement: The physician or psychologist must provide an endorsement. Neglecting this step can result in the application being deemed incomplete.

6. Inaccurate Contact Information: Providing incorrect telephone numbers or addresses can hinder communication. Always verify that contact details are accurate.

7. Not Providing a Date: The application requires a date of completion. Failing to include this can lead to confusion regarding the timeline of the application.

8. Neglecting to Review the Law: The application references specific laws and provisions. Not reviewing these can lead to a lack of understanding of the process and rights involved.

9. Ignoring the Non-Discrimination Clause: Failing to acknowledge the non-discrimination policy can lead to potential issues later. It's important to understand that services are provided fairly.

What is the purpose of the Maryland Admission form?

The Maryland Admission form is designed for individuals seeking voluntary admission to a behavioral health facility. It facilitates the process of obtaining care or treatment for a mental disorder, in accordance with Maryland law. The form must be completed and submitted to the facility's administrative head.

Who is eligible to apply for voluntary admission using this form?

Individuals who are 16 years old or older may apply for voluntary admission using this form. The applicant must have a mental disorder that is susceptible to treatment and must understand the nature of their request for admission. Additionally, they should be able to provide continuous assent to their retention in the facility and request their release when desired.

What information is required on the Maryland Admission form?

The form requires personal information such as the applicant's printed name, address, date of birth, and telephone number. Additionally, the applicant must sign the form to indicate their consent for admission. A physician or psychologist must also endorse the application, confirming the individual's mental disorder and their capacity to understand the treatment request.

What happens if an individual is denied admission?

If an individual is denied admission, particularly those aged 65 or older, a geriatric evaluation team must determine if there are less restrictive care options available. If such options exist, the team will inform the individual and assist them in obtaining the appropriate care.

Can an individual leave the facility after voluntary admission?

Yes, individuals who are admitted voluntarily can leave the facility at any time between 9 a.m. and 4 p.m. if their admission status remains voluntary. If the individual requests release after being formally admitted, they cannot be held for more than three days unless their status changes to involuntary admission.

What is the role of the physician or psychologist in the admission process?

The physician or psychologist plays a crucial role in the admission process by examining the individual and providing an endorsement on the form. This endorsement confirms that the individual has a mental disorder, is capable of understanding their request for treatment, and can provide continuous assent to their admission.

What should an individual do if they experience discrimination during the admission process?

If an individual believes they have experienced discrimination, they may file a written complaint with the Director of the Behavioral Health Administration or the Office of Civil Rights at the U.S. Department of Health and Human Services. This ensures that any allegations of discrimination are formally addressed.

Is the admission process compliant with civil rights regulations?

Yes, the services and programs of the Maryland Department of Health and Mental Hygiene are provided on a non-discriminatory basis. The admission process complies with Article VI of the Civil Rights Act of 1964, ensuring that all individuals are treated fairly and without bias.