Form 10-603. Attorney's certificate.

STATE OF NEW MEXICO COUNTY OF _______________ __________________ JUDICIAL DISTRICT IN THE CHILDREN’S COURT No. __________ IN THE MATTER OF _______________________________ ATTORNEY’S CERTIFICATE I, ___________________________ (name of attorney), certify that on ____________________ (date) I met with the above named child who was born on ____________________ and explained the child’s rights under Sections 32A-6A-12 and 32A-6A-21 NMSA 1978. I further certify the following: (check only one) [ ] I am satisfied that the child understands these rights and voluntarily and knowingly desires to remain as a patient in a residential treatment or habilitation program. [ ] I do not believe that the child understands these rights. [ ] The child demands to be released. [ ] The child was discharged prior to the opportunity for advisement. ________________________________ Date ________________________________ Attorney’s signature ________________________________ Address ________________________________ Telephone number