FOR CLERK’S USE ONLY Name of Person Filing: _______________________________________ Mailing Address: _______________________________________ City, State, Zip Code: _______________________________________ Day/Evening Telephone: _______________________________________ ATLAS Number (if applicable) _______________________________________ Attorney Bar Number (if applicable) __________________________________ Representing: Self Petitioner Respondent SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case No. GC-______________________________ In the Matter of the Guardian/ Conservatorship of ORDER APPOINTING ATTORNEY, MEDICAL PROFESSIONAL AND COURT INVESTIGATOR FOR AN ADULT An Adult ____________________________________________ The Petition of _________________________ for appointment of a Guardian and Conservator of the above-captioned person, an Adult, and the Motion for Appointment of Attorney, Medical Professional and Investigator for an Adult, having come before the Court, and good cause appearing, IT IS ORDERED that: (A) _________________________, is appointed attorney for the above-captioned person, and shall attend the hearing on _____________________, 20______. (B) _________________________, is appointed physician, psychologist or registered nurse and shall file a written report with this Court on or before _______________, 20______, regarding the need for a Guardian/Conservator. (C) _________________________, is appointed investigator to interview the above-captioned person, and shall file a written report with this Court on or before _________________, 20________, regarding the need for a Guardian/ Conservator. DATED this day of , 20________. ___________________________ Judge of the Superior Court 10/04/06 American LegalNet, Inc. www.FormsWorkflow.com