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JDF 827 SC R6/1 9 ORDER APPOINTING GUARDIAN FOR MINOR Page 1 of 3  District Court  Denver Probate Court ___________________ County, Colorado Court Address: In the Interest of: Min or COURT USE ONLY Case Number: Division Courtroom ORDER APPOINTING GUARDIAN FOR MINOR Upon consideration of the Petition for Appointment of Guardian for the above minor and hearing on (date), The court has considered any expressed wishes of the m inor concerning the selection of the guardian. The c ourt has considered the powers and duties of the guardian, the scope of the guardianship, and the priority and qualifications of the n ominee. The court finds, determines and orders : 1. Venue is proper and required notices have been given or waived. 2. The minor was born on (date). 3. An interested person seeks appointment of a guardian. 4. The minor’s best interest will be served by the appointment of a guardian. 5.  The minor’s parents’ consent to the appointment of a guardian.  The minor’s parents’ parental rights have been terminated by prior court order.  The minor’s parents are deceased.  The minor’s parents are unwilling or unable to exercise their parental rights.  Guardianship has previously been granted to a third party who has died or become incapacitated and the guardian has not appointed a successor g uardian by will or written instrument. 6. The court appoints the following person as guardian for the minor : Name: Street address: City: State: Zip Code: Mailing Address, if different: City: ___________ State: ____________ Zip Code: ____________ Prim ary Phone: Alternate Phone :____________________ Email Address : _________________________________ 7. The guardian must promptly notify the c ourt if the guardian’s home address, email address, or phone number changes and of any change of address for the minor . 8. The guardian may not establish or move the minor’s custodial dwelling outside the State of Colorado without a court order . JDF 827 SC R6/1 9 ORDER APPOINTING GUARDIAN FOR MINOR Page 2 of 3 9. Within 30 days of appointment, the guardian must provide a copy of this Order Appointing Guardian for Minor to the minor if 12 years or older and persons given notice of the petitio n and must advise those persons using Notice of Appointment of Guardian and/or Conservator ( JDF 812) that they have the right to request termination or modification of the guardianship. 10.  The guardian must file the annual Guardian’s Report - Minor (JDF 834) with the court each year by  the minor’s birthday or  by (date). 11. Copies of all future c ourt filings must be provided to the following interested persons: Name Relationship to Minor The minor if 12 years or older at the time of mailing Parent or adult nearest in kinship Parent or adult nearest in kinship Guardian 12. The guardian is authorized to access the minor’s medical records and information. The g uardian is deemed to be the m inor’s personal representative for all purposes relating to the m inor’s protected health information, as provided in HIPAA, Section 45 CFR 164.502(g)(2). 13. Letters of Guardianship will be issued. The Letters will expire on the m inor’s 18 th birthday, (date), unless otherwise ordered by the c ourt.  The powers and duties of the g uardian are unrestricted.  The powers and duties of the g uardian are limited by the following restrictions: 14. The appointment is pursuant to § 15- 14-204(2.5)( b), C.R.S . Letters of Guardianship will be issued. The Letters will expire on the minor’s 21 st birthday, (date), unless otherwise ordered by the court.  The powers and duties of the guardian are unrestricted.  The powers and duties of the guardian are limited by the following restrictions:  A separate Order regarding the court’s findings establishing the minor’s eligibility for classification as a special immigrant juvenile was issued. JDF 827 SC R6/1 9 ORDER APPOINTING GUARDIAN FOR MINOR Page 3 of 3 15. The court further orders: Date: ____________ ______________ _____________________ _________________  Judge  Magistrate