Case No.: ________________
Petitioner, Family Division
Upon ( ) Petitioner’s ( ) Respondent’s ( ) Court’s own motion to appoint guardian ad
litem for the minor child(ren) herein and the Court finding that
a. verified allegations of child abuse or neglect as defined in section 415.503(3), Florida
Statutes, have been made and are determined to be well-founded,
____ b. it is otherwise in the best interests of the child(ren) that a guardian ad litem be
appointed to advance the best interests of the minor child(ren) because:
, it is ORDERED:
1. A guardian ad litem shall be appointed for the minor child(ren),
_____________________ {birth date(s)}, _______________________{gender}, now
residing at
{street address}.
2. The State of Florida Guardian Ad Litem Program for the Fifteenth Judicial Circuit shall
assign a certified guardian ad litem for the minor child(ren). Upon filing of the Notice of
Acceptance, the guardian shall be served c/o Guardian ad Litem Program, 205 North
Dixie Highway, Suite 2.1100, West Palm Beach, Florida 33401.
Pursuant to the State of Florida Guardian ad Litem Standards of Operation adopted by
the Supreme Court of Florida, if the Guardian ad Litem Program is appointed in the
absence of a well founded allegation of abuse or neglect, an automatic discharge by the
Court will occur upon filing of a Motion to Discharge by the Program if the Program does
not have sufficient volunteer and/or supervisory resources available to accommodate
this appointment.
_____________________________________{name}, an attorney in good standing with
The Florida Bar, is appointed to serve as a private guardian ad litem for the above minor
child(ren). The fees of the private guardian shall be paid by:
( ) Petitioner ( ) Respondent ( ) each party equally ( ) other {specify}________
3. The guardian ad litem is a party to any judicial proceeding from the date of this order
until the date of discharge and shall have all of the powers, privileges, and
responsibilities authorized in section 61.403, F.S., to the extent necessary to advance
the best interests of the minor child(ren).
4. The guardian ad litem must be provided with copies of all pleadings, notices,
stipulations, and other documents filed in this action and is entitled to reasonable notice
before any action affecting the child(ren) is taken by the parties, their counsel, or the
Court. The guardian is entitled to be present at depositions, hearings, or other
proceedings concerning the child(ren).
5. Upon presentation of this order to any agency, hospital, organization, school, person or
office, including the Clerk of this Court, Department of Children and Families, human
service agencies and/or child-caring agencies, medical and mental health professionals,
including doctors, nurses, pediatricians, psychologists, psychiatrists, counselors and
staff, and law enforcement agencies, the guardian ad litem hereby designated, Guardian
Ad Litem Circuit Director, or program staff are hereby authorized to inspect and copy any
records relating to the above-named child(ren) without consent of the child(ren),
the child(ren)’s parents or care givers. However, before the guardian ad litem is given
access to records of psychologist and/or psychiatrist, the minor child(ren) is entitled to
notice and opportunity to be heard. Moreover, the mature minor child(ren) has the right
to assert psychotherapist/patient privilege. See S.C., a minor child v. Guardian Ad
Litem, 845 So. 2d 953 (Fla. 4th DCA 2003)..
The guardian ad litem shall maintain information received from any source described in
section 61.403(2), Florida Statutes, as confidential and shall not disclose such
information except in reports to the Court served upon parties to this cause and their
counsel, or as directed by the Court.
7. The parties or any other person entrusted by the parties with the care of the minor
child(ren) shall allow the guardian ad litem access to the minor child(ren) at reasonable
times and locations. No person shall obstruct the guardian from the minor child(ren).
8. The guardian shall file a written report with the Court, which may include recommenda-
tions and a statement of the wishes of the minor child(ren). The report must be filed and
served on all parties prior to the hearing at which it will be presented unless the Court
waives such time period. The report shall address the following, subject to any
conditions ordered by this Court:
a. alleged abuse or neglect;
b. preference(s) of the child(ren);
c. parent and child relationship;
d. medical need(s) of the child(ren);
e. education;
f. substance abuse
g. conditions of the home
____ h. best interest of the child(ren) regarding scientific tests
____ I. other______________________________________
9. The guardian ad litem is automatically discharged without further order 30 days after the
entry of a final order or judgment in this proceeding, unless otherwise ordered.
DONE AND ORDERED in Palm Beach County, Florida, this
day of ________, 2004.
Copies furnished to:
Petitioner (or his or her attorney)________________________________________________________
Respondent (or his or her attorney)______________________________________________________
Guardian Ad Litem Program, 205 N. Dixie Highway, Juvenile Wing, Rm. 2.1100, W.P.B., FL 33402 (inter-