5. ______________________________ is a minor child, date of birth,
____________________,
6. ______________________________ is a minor child, date of birth,
____________________,
7. That it is necessary that the minor children be appointed a Guardian to meet their
physical and emotional needs.
. That it appears to the Court that ________________________________ is an
appropriate person to assume the authority to act in the circumstances.
IT IS THEREFORE ORDERED, ADJUDGED, AND DECREED by the Court that
___________________________________ is hereby appointed as General Guardian of the /F1 15.570800 Tf`rrPrhrˆr¨r rÐrHr ˆqÐq°qðq¨qqHq qàq@qÀqøqXq`q0qhq¨q PqHqØqG*XDUGLDQ RI WKH
person and estate of
___________________________________________,
___________________________________________,
___________________________________________,
___________________________________________,
(names of children)
IT IS FURTHER ORDERED, ADJUDGED, AND DECREED by the Court that
BBB as General Guardian of the person and estate of the BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB DVGeneral Guardian /F1 15.570800 TfG
above named minor children, shall have the following power and authority regarding the person
the above named minor children:
a) ______________________________ shall have the sole authority to provide for the
care, custody, and control of said child, including but not limited to, the authority to make
inquiry, discuss, and obtain any and all information regarding the above named minor
children’s current physical, medical, and psychological condition, and to receive
information from any of the above named minor children’s current or past medical
providers;
b) ________________________________ shall have the sole authority to consent to any
and all routine or necessary medical care on behalf of the above named minor children;
IT IS THE FURTHER ORDER OF THIS COURT that hearing upon said General
Guardianship is hereby set for review on the _____ day of __________________________,
20___ at the hour of _____ o’clock ___.m.
IT IS FURTHER ORDERED that the Guardian shall file an annual report with this Court
on or before the ______ day of _______________________, 20____.
8
