Fillable Mpc701 Decree And Order Expansion Modification Limiation Guardian Fill (Commonwealth of Massachusetts)

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Mpc701 Decree And Order Expansion Modification Limiation Guardian Fill (Commonwealth of Massachusetts)

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BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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MPC 701 (5/30/11) JSA, ORTO
of
page
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
EXPANSION
LIMITATION
MODIFICATION
OF THE POWERS OF A GUARDIAN
Last Name
First Name
Middle Name
Incapacitated Person (Respondent)
DECREE AND ORDER OF
TEMPORARY ORDER OF
Division
On the Petition for:
Limitation
Modification
Expansion
of the Powers of a Guardian filed on
.
The Court finds that:
Limitation
Modification
Expansion
given to the Respondent and all other notice has been properly given or waived, and that it is in the best interests of the
Respondent that the powers of the Guardian be:
of the Powers of the Guardian
(name)
is appropriate, that notice has been properly
EXPANDED. The Court orders the Guardian's powers are expanded to include the following power(s) to:
admit Respondent to a nursing facility;
revoke the Health Care Proxy of Respondent;
apply for health insurance benefits including MassHealth on behalf of Respondent;
Obtain copies of statements or any other records from banks, insurance companies or other financial institutions
verifying balances and transactions for accounts standing in the name of the Incapacitated Person, individually or
jointly with another.
Other:
EXPANDED. After making a substituted determination (see separate findings), the court authorizes treatment
of the Incapacitated Person:
with antipsychotic medication in accordance with a treatment plan dated
which is incorporated herein by reference and which shall be reviewed on or before
and, if not sooner extended, shall expire on
. The appointment of Counsel for the
Incapacitated Person is extended for the limited purpose of representing the Incapacitated Person's interests in any
proceeding to renew and/or amend the treatment plan.
for the following treatment or action:
MODIFIED. The Court orders the Guardian's powers be modified as follows:
MPC 701 (5/30/11) JSA, ORTO
In the Interests of:
of
page
Last Name
First Name
Middle Name
Docket No.
LIMITED. The Court orders the Guardian's powers be limited as follows:
The Court further Orders that:
This is a Temporary Order and the expansion, modification, or limitation of the powers of the Guardian stated herein
shall expire in ninety (90) days or on
(date)
.
Date:
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Mpc701 Decree And Order Expansion Modification Limiation Guardian Fill (Commonwealth of Massachusetts)

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Completed 27 July 2020

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