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FORM SUMMARY Name of Form: Order Appointing Guardian Ad Litem (Annual Review of Order Authorizing Involuntary Administration of Psychotropic Medications) Form Number: GN-4240 Statutory Reference: §55.19(2), Wisconsin Statutes Benchbook Reference: Purpose of Form: Order to appoint GAL annual review of order authorizing involuntary administration of psychotropic medications. Who Completes It: BY THE COURT: Circuit Court Judge/Circuit Court Commissioner. THIS IS A FINAL ORDER FOR THE PURPOSE OF APPEAL IF SIGNED BY A CIRCUIT COURT JUDGE. Distribution of Form: Accompanying Forms: New Form/Modification: New form. Modifications: Comments: About this Form: This form is the product of the Wisconsin Records Management Committee, a committee of the Director of State Court's Office and a mandate of the Wisconsin Judicial Conference. If you have additional information that does not change the meaning of the form, attach it on a separate page. The form itself shall not be altered. Approval Date: 05/02/2019 Release Date: 07/12/2019 Page 1

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