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Get Maryland State Parks Pass Form

Signature of Physician or Appropriate Health Care Provider Print Clearly or Type Physician s or Health Care Provider s Information Address of Physician The Access Maryland State Park Pass is a free lifetime entrance pass to those State operated parks with entrance service charges. Application for Access Maryland State Park Pass for Persons with Disabilities Non-transferable Maryland Park Service Please Type or Print Clearly Name First Middle Initial Last Address Street City State Zip Code Date of Birth Height Weight Telephone Number Hair Color Eye Color Nature of Disability TO BE COMPLETED BY PHYSICIAN OR APPROPRIATE HEALTH CARE PROVIDER Description and Location of Disability I hereby certify that the above diagnosis is correct and that the disability is PERMANENT AND SUBSTANTIALLY LIMITS ONE OR MORE MAJOR LIFE ACTIVITIES of the above-named applicant. It is issued to persons who have a permanent physical or mental impairment that substantially limits one or more major life activities. Having reserved parking tags or a handicapped placard from the Motor Vehicle Administration does not constitute disability status for the purpose of this pass. Confirmation from a physician or appropriate health care provider is still required* The Access Maryland State Park Pass admits the cardholder and one other person only. Complete application and return to Maryland Department of Natural Resources Tawes State Office Building 580 Taylor Avenue E-3 Annapolis Maryland 21401 Attention Access Maryland Pass Application Upon review and approval of application your Access Maryland State Park Pass will be mailed to you. It is issued to persons who have a permanent physical or mental impairment that substantially limits one or more major life activities. Having reserved parking tags or a handicapped placard from the Motor Vehicle Administration does not constitute disability status for the purpose of this pass. Having reserved parking tags or a handicapped placard from the Motor Vehicle Administration does not constitute disability status for the purpose of this pass. Confirmation from a physician or appropriate health care provider is still required* The Access Maryland State Park Pass admits the cardholder and one other person only. Confirmation from a physician or appropriate health care provider is still required* The Access Maryland State Park Pass admits the cardholder and one other person only. Complete application and return to Maryland Department of Natural Resources Tawes State Office Building 580 Taylor Avenue E-3 Annapolis Maryland 21401 Attention Access Maryland Pass Application Upon review and approval of application your Access Maryland State Park Pass will be mailed to you. It is issued to persons who have a permanent physical or mental impairment that substantially limits one or more major life activities. Having reserved parking tags or a handicapped placard from the Motor Vehicle Administration does not constitute disability status for the purpose of this pass. Confirmation from a physician or appropriate health care provider is still required* The Access Maryland State Park Pass admits the cardholder and one other person only.

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