Legal Guardianship Intake Form

Legal Guardianship Intake Form

This Legal Guardianship Intake and Engagement Agreement is made on Date: by and between Petitioner Name: whose primary address is and Attorney/Representative Name: .

RECITALS

WHEREAS, Petitioner seeks appointment as legal guardian of the person and/or estate of the proposed ward, Ward Name: (the "Ward"), born on , because Petitioner believes the Ward is incapacitated and requires guardianship for personal and/or financial affairs.

WHEREAS, Petitioner requests that Attorney/Representative evaluate, prepare, and, if authorized, file necessary petitions, supporting declarations, and other court papers and appear on behalf of Petitioner in guardianship proceedings limited to the scope described herein.

NOW THEREFORE, in consideration of the mutual covenants and the information provided below, the parties agree as follows:

1. DEFINITIONS

As used in this agreement: "Ward" means the person identified above for whom guardianship is sought. "Petitioner" means the individual seeking appointment. "Guardian" refers to any person appointed by the court to make personal or financial decisions for the Ward. "Estate" includes the Ward's assets, benefits, and financial accounts.

2. SCOPE OF REPRESENTATION

Attorney/Representative will provide legal services to Petitioner limited to intake evaluation, preparation of a guardianship petition and supporting documents, filing the petition with the appropriate court, serving required notices, representing Petitioner at the initial hearing, and advising regarding temporary or emergency relief. Additional services beyond the initial petition and hearing (including appeals, complex asset administration, or contested trials) will require a separate agreement and fee arrangement.

3. PETITIONER AND WARD INFORMATION

4. TYPE OF GUARDIANSHIP SOUGHT

Please indicate the type(s) of guardianship being requested:

Personal guardianship (decisions about care, residence, medical treatment)
Estate/financial guardianship (management of assets, benefits, banking)
Limited guardianship (specific areas restricted by court)
Temporary or emergency guardianship

5. MEDICAL, BENEFITS, AND SUPPORT INFORMATION

6. ASSETS AND DOCUMENTS

Indicate documents in your possession or that you can obtain (check all that apply) and provide brief details below.

Birth certificate
Recent medical records
Bank/financial statements
Existing power of attorney or advance directive
Existing court orders (custody, protection)

7. PETITIONER REPRESENTATIONS

Petitioner represents and warrants under penalty of perjury that the information provided in this form is true and correct to the best of Petitioner’s knowledge, that Petitioner is willing to act as proposed guardian if appointed, and that Petitioner will promptly disclose any additional information or documents that may affect the guardianship proceeding, including conflicts of interest or existing legal claims.

8. AUTHORIZATION TO OBTAIN RECORDS

Petitioner authorizes Attorney/Representative to request, obtain, and review medical, mental health, educational, benefit, employment, and financial records reasonably necessary to prepare the guardianship petition and to disclose such information to the court and opposing parties as required by law. Petitioner understands that such disclosures may include sensitive personal information and consents to the limited disclosure described herein.

9. FEES, RETAINER, AND BILLING

Fee arrangement: Attorney/Representative will charge for services at negotiated hourly rates and will require a retainer prior to initiating filings. Petitioner agrees to provide a retainer in the amount Retainer Amount: . The retainer will be held in trust and applied to fees and costs; Petitioner will be billed monthly for fees incurred. Costs such as filing fees, service of process, and expert fees will be advanced by Petitioner on demand.

10. NOTICES

All notices required or permitted under this agreement must be in writing and delivered to the addresses below.

11. AMENDMENTS; WAIVER; COUNTERPARTS

This agreement may be amended only by a written instrument signed by both parties. No waiver of any provision will be effective unless in writing. This agreement may be executed in counterparts, each of which is an original and all of which constitute one instrument.

12. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This agreement shall be governed by the laws of the state in which the guardianship petition is filed without regard to conflict-of-law principles. This document constitutes the entire agreement between the parties with respect to the subject matter and supersedes prior discussions and writings. If any provision is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

13. COUNSELING, MEDIATION, AND ALTERNATIVES

Where appropriate, Attorney/Representative will advise Petitioner regarding non-judicial alternatives such as supported decision-making agreements, guardianship alternatives, or mediation. Attorney/Representative does not guarantee any particular court outcome.

14. ADDITIONAL INFORMATION

CERTIFICATION AND CONSENT

By signing below, Petitioner certifies under penalty of perjury that the foregoing information is true and complete to the best of Petitioner’s knowledge; authorizes Attorney/Representative to take the actions described in this agreement; acknowledges receipt of the terms regarding fees and retainer; and understands that Attorney/Representative may withdraw upon reasonable notice if Petitioner fails to comply with the terms or for any ethical conflict.

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