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Order Granting Petition (To Authorize Physician To Perform Abortion) Form. This is a Arizona form and can be use in Abortion Statewide.
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Tags: Order Granting Petition (To Authorize Physician To Perform Abortion), Arizona Statewide, Abortion
SUPERIOR COURT OF ARIZONA
_________________ COUNTY
IN THE MATTER OF:
)
)
___________________________,
)
a minor
)
[Use true name of petitioner]
)
)
___________________________________ )
CASE NO. _____________________
ORDER GRANTING PETITION
A hearing was held on a Petition to Authorize Physician to Perform Abortion on this ___
day of __________, 20___. The petitioner was present. The record was kept by_____________.
The name of the court reporter, if applicable, is _______________________________. The
petitioner was sworn and testified.
Based on the evidence presented, THE COURT FINDS AS FOLLOWS:
1.
_______________was appointed by the court to act as a guardian ad litem for petitioner.
2.
____ The petitioner was represented by an attorney, _________________________, who
was present at the hearing; OR
____ The petitioner was advised of her right to court-appointed counsel and has
knowingly and intelligently waived her right to counsel.
3.
____ The petitioner is mature and capable of giving informed consent to the proposed
abortion; OR
____ The petitioner is not mature, but it is in the petitioner’s best interests to have the
proposed abortion without having to obtain consent from one of her parents or her
guardian or conservator, based on the following factors:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
07.25.2012
American LegalNet, Inc.
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Case No: _____________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
THE COURT CONCLUDES AND ORDERS:
1.
The requirements of A.R.S. § 36-2152(B) have been met.
2.
The petition is granted. A physician chosen by the petitioner is hereby authorized to
perform an abortion for petitioner without having to obtain the consent of her parents,
guardian, or conservator.
3.
The clerk of the court shall provide petitioner or her attorney with a certified copy of this
order forthwith at no cost.
4.
No member of the public shall inspect or obtain access to copies of this order or any other
documents or records relating to this matter without the consent of the petitioner.
5.
The record and evidence in this matter shall remain sealed and confidential.
6.
No minute entry shall be issued.
DATE:___________
___________________________________
Judge of the Superior Court
07.25.12
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Case No: _____________________________
A copy hereof was
hand-delivered/mailed
to petitioner/petitioner’s attorney,
this ___ day of _______, 20___.
____________________________
Mailed/hand-delivered to
guardian ad litem
on _______________, 20___.
_____________________________
07.25.12
3
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www.FormsWorkFlow.com