CAUSENO._________________
§ INTHEPROBATECOURT
§
§ OF
§
THESTATEOFTEXAS
FORTHEBESTINTEREST
ANDPROTECTIONOF
§
DENTONCOUNTY,TEXAS
REQUESTFORJURY
TOTHEHONORABLEJUDGEOFSAIDCOURT:
Nowcomes, ,Attorneyfor ,ProposedPatienthereinand
respectfullyrequestsaJuryTrialinthiscause,pursuanttoSection574.032(b)oftheTexasHealthand
SafetyCode.
DATEDthisthe______dayof_________________,20____.
____________________________________
AttorneyforProposed
Patient
____________________________________
ProposedPatient
initials
Enter Attorney's Name
Enter Patient's Name
Enter Attorney's Name
Enter Patient's Name