Consent Order And Referral For Testing (1035) printable pdf download

Consent Order And Referral For Testing (1035)

IN THE CIRCUIT COURT FOR MONTGOMERY COUNTY, MARYLAND

Plaintiff

vs.

Case No. _________________

Defendant

CONSENT ORDER AND REFERRAL FOR TESTING

(1035 )

By consent of the Plaintiff and Defendant, as evidenced by the signatures below, it is this

______ day of __________________, 20___, by the Circuit Court for Montgomery County,

Maryland,

ORDERED, that Family Division Services shall provide the Plaintiff and Defendant

copies of all records received from Montgomery County Adult Addiction Services, Addiction

Services Coordination, Urine Monitoring Program, regarding the above captioned case; and it is

further

ORDERED, that the Plaintiff and Defendant shall maintain the aforementioned records

for use in this litigation only; and it is further

ORDERED, that the Plaintiff and Defendant shall not provide the original or any

facsimile of these records to any persons or third parties without further Order of this Court; and

it is further

ORDERED, that __________________________ is to appear on _______________, 20

___at ____ a.m./p.m. at Family Division Services, Room 220, for completion of a release form

for the following:

F:\Family Service Orders\Drug Test Order-Referral and Instructions-rev 7-02.doc

Consent Order And Referral For Testing (1035)