Adult Guardianship Petition

ADULT GUARDIANSHIP PETITION

TABLE OF CONTENTS

1. Caption and Case Information
2. Petitioner Information
3. Proposed Ward Information
4. Basis for Guardianship
5. Less Restrictive Alternatives Considered
6. Powers Requested
7. Proposed Guardian Information
8. Notice and Service
9. Medical Evidence
10. Proposed Care Plan
11. Prayer for Relief
12. Verification and Signature
13. State-Specific Variations

1. CAPTION AND CASE INFORMATION

IN THE [☐ PROBATE / ☐ SURROGATE / ☐ CIRCUIT / ☐ SUPERIOR] COURT
[________________] COUNTY, STATE OF [________________]

IN THE MATTER OF:
[PROPOSED WARD NAME],
An Alleged Incapacitated Person.

Case No.: [________________]

2. PETITIONER INFORMATION

The Petitioner is ☐ related to / ☐ unrelated to the proposed ward and has standing to file this petition pursuant to [STATE STATUTE].

3. PROPOSED WARD INFORMATION

4. BASIS FOR GUARDIANSHIP

4.1 Nature of Incapacity.

The proposed ward is unable to manage [☐ personal care / ☐ financial affairs / ☐ both] because of:

☐ Dementia / Alzheimer's disease
☐ Intellectual or developmental disability
☐ Traumatic brain injury
☐ Stroke / cerebrovascular accident
☐ Mental illness (specify): [________________________________]
☐ Substance abuse disorder
☐ Physical incapacity requiring decision-making assistance
☐ Other: [________________________________]

4.2 Functional Limitations.

The proposed ward is unable to:

☐ Make informed medical decisions
☐ Manage medications safely
☐ Prepare meals or maintain nutrition
☐ Maintain personal hygiene
☐ Manage household affairs
☐ Manage finances, pay bills, or handle banking
☐ Protect against financial exploitation
☐ Understand and evaluate information relevant to decisions
☐ Communicate decisions effectively
☐ Appreciate the consequences of decisions

4.3 Specific Facts Supporting Petition.

[________________________________]
[________________________________]
[________________________________]

5. LESS RESTRICTIVE ALTERNATIVES CONSIDERED

The Petitioner has considered the following less restrictive alternatives and states why each is insufficient:

6. POWERS REQUESTED

6A. Guardianship of the Person (check all requested):

☐ Determine residence and living arrangements
☐ Consent to or refuse medical treatment
☐ Consent to or refuse mental health treatment
☐ Make end-of-life care decisions
☐ Arrange for education, training, or rehabilitation
☐ Consent to marriage or divorce proceedings
☐ Make decisions regarding social activities and relationships
☐ Apply for government benefits on behalf of the ward
☐ Access protected health information under HIPAA

6B. Guardianship of the Estate / Conservatorship (check all requested):

☐ Manage income and assets
☐ Pay bills and manage expenses
☐ Manage real property
☐ File tax returns
☐ Make investment decisions
☐ Apply for government benefits
☐ Manage insurance policies
☐ Commence or defend litigation on behalf of the ward
☐ Sell, lease, or encumber real property (with court approval)

6C. Type of Guardianship Requested:

☐ Full / Plenary guardianship
☐ Limited guardianship (specify powers): [________________________________]
☐ Emergency / Temporary guardianship (duration: [____] days)
☐ Guardianship of the person only
☐ Guardianship of the estate only

7. PROPOSED GUARDIAN INFORMATION

7.1 Qualifications.

☐ No felony convictions
☐ No prior removal as guardian or fiduciary
☐ No bankruptcy within past 7 years
☐ Willing and able to serve as guardian
☐ Completed or will complete guardian training (if required by state)
☐ Willing to post bond in the amount of $[________________] (if required)

7.2 Potential Conflicts.

☐ No conflicts of interest exist
☐ The following potential conflicts are disclosed: [________________________________]

8. NOTICE AND SERVICE

The following persons are entitled to notice of this proceeding and shall be served:

☐ The proposed ward has been personally served with a copy of this petition.
☐ A court-appointed attorney / guardian ad litem is requested for the proposed ward.

9. MEDICAL EVIDENCE

9.1 Examining Physician / Psychologist Report.

9.2 The examiner has determined that the proposed ward:

☐ Lacks capacity to make informed decisions about personal care
☐ Lacks capacity to manage financial affairs
☐ Is at risk of harm without a guardian
☐ Cannot be adequately protected by less restrictive means

☐ Physician/psychologist report is attached as Exhibit [____].

10. PROPOSED CARE PLAN

10.1 Living Arrangements. The proposed guardian intends to [________________________________].

10.2 Medical Care. The proposed guardian will ensure [________________________________].

10.3 Financial Management. The proposed guardian will [________________________________].

10.4 Social and Recreational. The proposed guardian will promote [________________________________].

11. PRAYER FOR RELIEF

WHEREFORE, Petitioner respectfully requests that this Court:

1. Appoint [PROPOSED GUARDIAN NAME] as [☐ Guardian of the Person / ☐ Guardian of the Estate / ☐ Guardian of the Person and Estate] of [PROPOSED WARD NAME];
2. Issue Letters of Guardianship to the appointed guardian;
3. Set bond in the amount of $[________________] or waive bond;
4. Authorize the guardian to exercise the powers set forth in Section 6 above;
5. Appoint counsel or a guardian ad litem for the proposed ward;
6. Schedule a hearing on this petition;
7. Grant such other and further relief as this Court deems just and appropriate.

12. VERIFICATION AND SIGNATURE

I, [PETITIONER NAME], declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge and belief.

_______________________________
Petitioner Signature

Date: [__/__/____]

_______________________________
[ATTORNEY NAME], Esq.
[BAR NUMBER]
[FIRM NAME]
[ADDRESS]
[PHONE] | [EMAIL]

Attorney for Petitioner

13. STATE-SPECIFIC VARIATIONS

This template is for informational purposes only. Guardianship proceedings affect fundamental rights and require strict procedural compliance. Engage qualified legal counsel before filing.