Fill and Sign the Guardianship of an Adultthe Law Firm of Bruce a Danford Form

CPC 32-V R7/00 VISITOR’S REPORT  Guardianship Proceedings  Conservatorship Proceedings Page 1 of 4This form conforms in substance to CPC 32-V. District Court  Denver Probate Court_________________________________________ County, ColoradoCourt 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. You have the right to retain and consult with an attorney of your own choosing at your own expense. If you cannot afford to pay an attorney, one will be provided by the Court without cost to you. Do you have an attorney?  Yes  No (If yes) Who is it? _________________________________________________________________ (If no) Do you want an attorney appointed to represent you?  Yes  No 3. Do you understand that under the law you have the following rights: to be present in person at any court proceeding and to see or hear all evidence bearing on your condition; to be represented by counsel; to present evidence; to cross-examine witnesses, including any court-appointed visitor or physician; to trial by jury upon written demand and without payment of a jury demand fee; to have a closed hearing on any issue; to contest the Petition; to object to the appointment of the proposed guardian or h______ powers or duties; to object to the creation of the proposed guardianship or the scope or duration thereof; to have a guardian ad litem appointed to represent your interests if the Court determines that a need for such representation exists; and to have all or a portion of the compensation of any court-appointed visitor, attorney, guardian ad litem or physician paid by the Court or the Petitioner if you cannot afford to pay it?  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  NoCheck appropriate boxes.NOTE: Section 15-14-303(2)(f) of the Colorado Probate Code requires the Visitor to make his investigation and to forward this Report to the Court, with copies to the allegedly incapacitated person, and to the person seeking appointment as guardian and his attorney, within ten days after the Visitor’s appointment, unless an extension of time has been granted by the Court for good cause shown. This form may be modified for use in connection with Conservatorship proceedings under Section 15-14-407(2) of the Colorado Probate Code. CPC 32-V R7/00 VISITOR’S REPORT  Guardianship Proceedings  Conservatorship Proceedings Page 2 of 4This form conforms in substance to CPC 32-V. 6. Do you need help caring for yourself?  Yes  No (If yes) In what areas? _______________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Who would you like to help care for you? ____________________________________________________________ _____________________________________________________________________________________________ 7. Do you know ______________________________________________________________, the proposed Guardian?  Yes  No a. How do you feel about having h_____ appointed as your Guardian? ____________________________________ ___________________________________________________________________________________________ b. Do you feel any of _____ powers or duties as your Guardian should be limited or restricted in any way?  Yes  No (If yes) What specific limitations or restrictions do you feel should be imposed? ___________________________________________________________________________________________ ___________________________________________________________________________________________ c. How do you feel about the proposed guardianship? _________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ d. How do you feel about the proposed scope and duration of the proposed guardianship? ____________________ ___________________________________________________________________________________________ 8. Where do you live? _____________________________________________________________________________ _____________________________________________________________________________________________ 9. Do you wish to  waive  confirm your prior waiver of service on you of notice of the hearing in these guardianship proceedings?  Yes  No E. Names of third person(s) present during interview of Person (if any): ________________________________________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: _______________________________________________________________________________ _____________________________________________________________________________________________ CPC 32-V R7/00 VISITOR’S REPORT  Guardianship Proceedings  Conservatorship Proceedings Page 3 of 4This form conforms in substance to CPC 32-V. 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): ___________________________________________________________________________________ ________________________________________________________________________________________________ CPC 32-V R7/00 VISITOR’S REPORT  Guardianship Proceedings  Conservatorship Proceedings Page 4 of 4This form conforms in substance to CPC 32-V.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): _______________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________DATE: ______________________________________ ___________________________________________Signature of Court Visitor