Guardianship of an Adult

Visitor’s Report

District Court Denver Probate Court

Court Address:

IN THE MATTER OF:

Incapacitated Person:

COURT USE ONLY

Attorney or Party Without Attorney (Name and Address):

Phone Number: E-mail:

FAX Number: Atty. Reg.#:

Case Number: Division Courtroom

VISITOR’S REPORT Guardianship Proceedings Conservatorship Proceedings

I, (name) , the court-appointed Visitor in this guardianship proceeding, submit the following report concerning the investigation which I conducted pursuant to Section 15-14-303(2) of the Colorado Probate Code.

I. Interview of Incapacitated Person:

A. Date and place of interview:

B. Oriented as to time and place? Yes No

C. Physical appearance:

D. Incapacitated Person asked and responded as follows:

1. Do you understand my explanation of the substance of the Petition; the nature, purpose and effect of the proceeding; and the general powers of duties of a guardian? Yes No

If no, explain here:

2. Do you have an attorney? Yes No If yes, who is it?

Do you want an attorney appointed to represent you? Yes No

3. Do you understand that under the law you have the following rights: Yes No

4. Who are your closest family members?

5. Do you have a doctor? Yes No If yes, who is it?

Is this the same doctor who provided the letter attached to the Petition filed in these proceedings? Yes No

II. Interview of Person seeking Appointment as Guardian:

A. Date and place of interview:

B. Person seeking appointment asked and responded as follows:

1. Name and address:

2. Relationship to Person:

3. Why does Person need help?

4. Where has Person resided during last three months?

5. Who, if anyone, has been caring for the Person during this period?

6. What changes in residence are contemplated?

III. Interview of Physicians and Other Persons Who have Evaluated or Rendered Care, Counsel, Treatment or Service to Incapacitated Person In Recent Past:

A. Date and place of interview of physician:

B. Physician asked and responded as follows:

1. Name:

2. Office Address:

3. Medical specialty:

4. Medical training:

5. Dates and types of evaluation of or care, counsel, treatment or service rendered to Person:

6. Diagnosis of Person’s condition (if any):

C. Date and place of interview of other person:

D. Other person asked and responded as follows:

1. Name:

2. Address:

3. Occupation:

4. Qualifications for occupation:

5. Dates and types of evaluation made of Person (if any):

6. Dates and types of care, counsel, treatment or service rendered to Person (if any):

7. Opinion (if any) regarding truth of grounds for appointment of a guardian alleged in Petition?

IV. Report on Condition of Incapacitated Person’s Present Place of Abode:

A. Date visited information otherwise obtained

B. Address:

C. Type of abode:

D. Condition (if a home):

1. Lawn and landscaping:

2. Exterior:

3. Interior:

a. Utilities working? Yes No

b. Clean? Yes No

c. Fire hazards? Yes No

d. Other (explain):

V. Report on Condition of Incapacitated Person’s Proposed Place of Detention or Residence:

A. Date visited information otherwise obtained

B. Location and type of place:

C. Condition:

VI. Conclusions of Visitor:

A. The nature and degree of the Person’s current incapacity or disability is as follows:

B. My evaluation of the fitness and appropriateness of the guardian seeking appointment is as follows:

C. I do do not recommend the powers of the guardian seeking appointment be limited.

If do, explain here:

D. I am of the opinion that an attorney should should not be appointed to represent the Person because

E. I am of the opinion that a guardian ad litem should should not be appointed to represent the Person because

F. I am of the opinion that a physician should should not be appointed to examine the Person because

VII. I do do not know the person alleged to be incapacitated;

I do do not know the person seeking appointment;

I do do not have a personal interest in these proceedings.

If do, explain here:

VIII. Additional comments (if any):