Fill and Sign the Temporary Guardian of Form

GN-3110, 05/14 Order and Notice of Hearing §§54.38(2), 54.38(6), 54.42(5), 54.44(1), 54.44(4), 55.09, 55.10, 55.11(3), and 55.14, W isconsin Stat utes This form shall not be modified. It may be supplemented with additional mater ial. A petition was filed by [Name] requesting: temporary guardian of person. estate. permanent guardian of person. estate. standby guardian of person. estate. successor guardian of person. estate. protective placement. protective services. involuntary administration of psychotropic medication. For guardianship, the court is satisfied as to compliance with §54.34, Wis. Stat s. THE COURT ORDERS: 1. The petition be heard before , Court Official, on [Date ] , at [Time] a.m. p.m. or when scheduled thereafter at [Location] . 2. A copy of this order and the petition shall be served upon the individual and guardian, if any, an d delivered to all interested persons and all others entitled to notice. 3. A copy of the physician or psychologists report shall be filed with the court and provi ded by the petitioner to the guardian ad litem and the attorney for the proposed ward or ward at least 96 hours before the time of the hear ing. 4. For protective placement , if the individual is developmentally disabled and is in or may be placed in a nursing or intermediate care facility, a copy of this order and the petition shall be served upon the appropriate board or designated agency. The board or agency shall submit to the court within 120 days of this order a plan for home or community-based care in the most integrated setting appropriate to the needs of the individual. 5. The individual, if able to attend, shall appear in person at the hearing, unless attendan ce is waived by the guardian ad litem and waiver is certified in writing to the court. 6. For protective placement or protective services, a copy of the comprehensive evaluation and any indepe ndent comprehensive evaluation shall be pro vided at least 96 hours in advance of the hearing to the individual’s guardian, agent under activated health care power of attorney, guardian ad litem, and to the individu al or individual’s attorney. NOTICE: If this is a Temporary Guardianship proceeding, the individual is notified of the right t o an attorney and the right to petition for reconsideration or modification of the temporary guardianship. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF Name Amended Order and Notice of Hearing Date of Birth Case No. If you require reasonable accommodations to participate in the court process due to a dis ability, please call at least 10 days prior to the scheduled court date. Please note that the court does not provide transportation. THIS IS A FINAL ORDER FOR PURPOSES OF APPEAL IF SIGNED BY A CIRCUIT COURT JUDGE. Please check with attorney/petitioner below for exact time and date. BY THE COURT: Circuit Court Judge/Circuit Court Commissioner Print or Type Name if not eSigned Date Name of Attorney/Petitioner Address Telephone Number Bar Number