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California Capacity Declaration—Conservatorship

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CAPACITY DECLARATION—CONSERVATORSHIP

CONSERVATORSHIP OF THE ESTATE OF PERSON (Name):

Page 1 of ___

TO PHYSICIAN, PSYCHOLOGIST, OR RELIGIOUS HEALING PRACTITIONER

A. is able to attend a court hearing to determine whether a conservator should be appointed to care for him or her. The court hearing is set for (date):

B. has the capacity to give informed consent to medical treatment.

C. has dementia and, if so, whether he or she needs to be placed in a secured-perimeter residential care facility for the elderly and whether he or she needs or would benefit from dementia medications.

COMPLETE ITEMS 1–4 OF THIS FORM IN ALL CASES.

1. (Name):

2. (Office address and telephone number):

3. I am

a California licensed physician psychologist acting within the scope of my licensure

an accredited practitioner of a religion whose tenets and practices call for reliance on prayer alone for healing, which religion is adhered to by the (proposed) conservatee. The (proposed) conservatee is under my treatment.

I last saw the (proposed) conservatee on (date):

4. The (proposed) conservatee physician psychologist acting within the scope of my licensure; with at least two years' experience in diagnosing dementia.

GENERAL INFORMATION

ABILITY TO ATTEND COURT HEARING

5. Because of medical inability, the proposed conservatee is NOT able to attend the court hearing (check all items below that apply)

(Proposed) conservatee (name):

is is NOT a patient under my continuing treatment.

(1) on the date set (see date in box in item A above).

(2) for the foreseeable future.

(3) until (date):

Supporting facts (State facts in the space below or check this box and state the facts in Attachment 5):

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF DECLARANT)

6. (continued)

EVALUATION OF (PROPOSED) CONSERVATEE'S MENTAL FUNCTIONS

A. Alertness and attention

(1) Levels of arousal (lethargic, responds only to vigorous and persistent stimulation, stupor):

(2) Orientation (types of orientation impaired):

(3) Ability to attend and concentrate:

B. Information processing. Ability to:

(1) Remember

i. Short-term memory

ii. Long-term memory

iii. Immediate recall

(2) Understand and communicate either verbally or otherwise

(3) Recognize familiar objects and persons

(4) Understand and appreciate quantities

(5) Reason using abstract concepts

(6) Plan, organize, and carry out actions

(7) Reason logically

C. Thought disorders

(1) Severely disorganized thinking

(2) Hallucinations

(3) Delusions

(4) Uncontrollable or intrusive thoughts

D. Ability to modulate mood and affect.

The (proposed) conservatee has does NOT have a pervasive and persistent or recurrent emotional state. If so, complete remainder of item 6D.

Anger Anxiety Fear Panic

Euphoria Depression Hopelessness Despair

Helplessness Apathy Indifference

E. The (proposed) conservatee's periods of impairment from the deficits indicated in items 6A–6D

(1) do NOT vary substantially in frequency, severity, or duration.

(2) do vary substantially in frequency, severity, or duration (explain):

F. (Optional) Other information regarding my evaluation of the (proposed) conservatee's mental function is:

ABILITY TO CONSENT TO MEDICAL TREATMENT

7. Based on the information above, it is my opinion that the (proposed) conservatee

a. has the capacity to give informed consent to any form of medical treatment.

b. lacks the capacity to give informed consent to any form of medical treatment.

Declarant must initial here if item 7b applies:

8. Number of pages attached:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF DECLARANT)

GC-335 [Rev. January 1, 2004] CAPACITY DECLARATION—CONSERVATORSHIP

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What the California Capacity Declaration—Conservatorship Is

The California Capacity Declaration—Conservatorship is a formal written statement used in probate proceedings to document an individual's mental capacity for purposes of appointing a conservator or for ongoing conservatorship oversight. The form records observations, medical findings, and the signer’s opinion about the person’s ability to make personal, medical, or financial decisions. Courts use the declaration as part of the petition or supporting evidence when determining whether a conservatorship is needed, what powers a conservator should have, and whether less-restrictive alternatives were considered.

Why this declaration matters in conservatorship cases

A clear capacity declaration helps courts evaluate decisionmaking ability, supports appropriate scope of conservator powers, and creates a dated record of medical and factual observations relevant to statutory requirements under California probate procedure.

Why this declaration matters in conservatorship cases

Who typically completes and relies on this declaration

The declaration is a legal document; accuracy and contemporaneous medical support improve its evidentiary weight in court.

  • Probate attorneys preparing petitions, exhibits, and legal summaries for the court and interested parties.
  • Treating physicians or psychologists who document clinical findings and capacity-related observations for the record.
  • Court investigators or social workers who corroborate facts and offer neutral assessments to the judge.

Primary signers and stakeholders

Conservator

A proposed conservator or appointed conservator signs attestations about actions taken and decisions made under court authority; their statements may be required for accountings and ongoing reports to the court.

Medical Examiner

Treating physicians or licensed mental health professionals provide expert observations and sign capacity declarations describing diagnosis, functional limitations, and the specific decisional tasks affected.

Essential information to include on the declaration

Full name: Conservatee’s legal name
Date of birth: MM/DD/YYYY format
Court case number: Probate docket number
Evaluator identity: Name and license
Capacity findings: Specific tasks affected
Signature block: Signature and date

Step-by-step: filling out the capacity declaration

Complete the form in sequence, attach supporting medical records, and ensure signatures and dates are present before filing.

  • 01
    1. Identify parties: Enter conservatee and evaluator names clearly.
  • 02
    2. State observations: Describe cognitive or functional findings with factual detail.
  • 03
    3. Attach evidence: Include assessments, chart notes, or test results.
  • 04
    4. Sign and date: Evaluator signs; include license or title.

How to prepare and route the form electronically

Configure a digital workflow that captures signatures, timestamps, and preserves attachments for court submission.

Field Configuration
Evaluator signature Require dated signature and license field
Attachments Permit PDF uploads, limit file size
Recipient routing Order: evaluator → attorney → court copy
Audit trail Record IP, timestamp, and actions

Digital signing and eSubmission considerations

Ensure the chosen platform can export court-ready PDFs, preserve metadata, and meet any jurisdictional notarization or witness requirements.

  • Integrations: Supports PDF and DOCX
  • Authentication: Email, SMS, or KBA options
  • Security: AES-256 at rest

Where to file or send the completed declaration

Follow local probate rules for filing one copy with the court and serving required parties; keep certified copies for records.

  • Filing with court: File as an exhibit to the conservatorship petition.
  • Serve interested parties: Provide copies to proposed conservatee and relatives.
  • Submit medical records: Attach supporting documentation to court filing.
  • Retain originals: Keep signed originals for counsel and court review.

Potential legal risks and consequences

Invalid declaration: Court may reject incomplete forms
Perjury exposure: False statements risk criminal charges
Probate delay: Insufficient evidence prolongs hearings
Financial liability: Improper conservatorship actions may incur damages
Privacy breaches: Protected health data exposure risks HIPAA penalties
Noncompliance: Missing filings can affect legal authority

Common mistakes to avoid when preparing the declaration

  • Leaving out the evaluator’s professional credentials or license number, which weakens the document’s evidentiary value in court.
  • Using vague language such as 'incapable' without describing specific tasks affected, resulting in insufficient detail for judicial findings.
  • Failing to attach contemporaneous medical records or test results, which can lead the judge to discount the declaration.
  • Omitting a clear signature date or failing to use required notarization or witness steps for the jurisdiction, which may invalidate the form.

Timing considerations and procedural deadlines

Track filing and post-appointment deadlines to ensure timely service, reports, and accountings required by the probate court.

At initial filing:

Include declaration as an exhibit to the conservatorship petition

Service deadlines:

Serve interested parties per local court rules after filing

Hearing notice:

Court schedules a hearing; timing varies by county

Post-appointment reporting:

Submit inventories and accountings when ordered by the court

Annual obligations:

Comply with recurring reports and medical reviews as required

Practical tips for accurate and efficient completion

Adopt consistent preparation habits to reduce errors and improve the declaration’s court acceptance rate.

Verify identity and names
Confirm the conservatee’s legal name and date of birth against government ID or medical records to avoid mismatches that can delay filings or cause the court to question the document’s reliability.
Document objective observations
Record concrete examples of impaired decisionmaking—such as inability to recall recent events or follow instructions—rather than general conclusions, so the court can see a factual basis for capacity findings.
Preserve supporting evidence
Attach dated clinical notes, cognitive tests, and relevant imaging reports; label each attachment and reference it in the declaration to make review straightforward for counsel and the court.
Follow local filing rules
Confirm county probate clerk requirements for exhibits, electronic filing formats, notarization, and service; compliance avoids rejection and shortens the path to hearing.

Practical examples of typical use

These concise scenarios illustrate how capacity declarations commonly support conservatorship proceedings.

Elder Law Clinic

An attorney documents progressive memory loss during a home visit and attaches cognitive testing results

  • The clinician signs a dated capacity declaration describing specific deficits
  • The court uses the declaration with medical exhibits to determine limited financial conservatorship while preserving healthcare autonomy.

Hospital Discharge

A treating physician documents inconsistent decisionmaking during a hospital stay and completes a capacity declaration

  • The record highlights immediate safety risks and need for temporary guardianship
  • The declaration expedites a temporary conservatorship hearing to secure short-term protective measures.

eSignature vendor comparison for signing and delivering the declaration

Basic pricing and capability markers for common eSignature vendors; signNow appears first per platform comparison conventions.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial, no card Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently asked questions about the capacity declaration

Answers to common procedural and technical questions when preparing or submitting a conservatorship capacity declaration.


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