SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN LUIS OBISPO STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: 1035 Palm Street, Room 385 Same as above San Luis Obispo, CA 93408 San Luis Obispo Branch FOR COURT USE ONLY CONSERVATORSHIP OF: ORDER APPOINTING COUNSEL FOR CONSERVATEE CASE NUMBER: 1. _______________________________________________________ is appointed as counsel for the proposed conservatee or conservatee in the above-captioned matter. The Court orders that appointed counsel shall have access to and authority to review and copy the medical records of the proposed conservatee or conservatee, without their consent, pursuant to Civil Code §56.10(b)(1). Counsel's acceptance of this appointment is certification to the Court that counsel currently meets the requirements of California Rule of Court 7.1101. 2. The next hearing date is scheduled for __________________________________________. 3. The Court directs that a written report be submitted on or before ___________________ . AND/ OR See Attachment 3 for other orders. 4. The Court appoints legal counsel based on the following: a. Petitioner is seeking dementia powers over the proposed conservatee. (Prob. Code, § 2356.5.) b. The Court determines that proposed conservatee or conservatee is not otherwise represented by counsel and that the appointment would be helpful to the resolution of the matter or is necessary to protect his or her interests. (Prob. Code, § 1470, subd. (a).) c. The proposed conservatee or conservatee is unable to retain legal counsel and requests the appointment of counsel to assist in one of the following proceedings: A proceeding to establish a conservatorship or to appoint a conservator; A proceeding to terminate a conservatorship; A proceeding to remove the conservator; A proceeding for a court order affecting the legal capacity of conservatee; or A proceeding to obtain an order authorizing removal of a temporary conservatee from the temporary Conservatee's place of residence. (Prob. Code, § 1471.) Form Adopted for Optional Use San Luis Obispo Superior Court Local Form PR008 Rev. 1/1/15 ORDER APPOINTING COUNSEL Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com CONSERVATORSHIP OF: CASE NUMBER: d. Based on information contained in the Court Investigator's report or obtained from another source, the Court determines that the appointment would be helpful to the resolution of the matter or is necessary to protect the interests of the conservatee or proposed conservatee. (Prob. Code, § 1471, subd. (b).) e. Petitioner seeks to establish a limited conservatorship. (Prob. Code, § 1471, subd. (c).) 5. The appointment is effective until the Court has discharged appointed counsel. Dated:__________________ ___________________________________ Judge of the Superior Court Form Adopted for Optional Use San Luis Obispo Superior Court Local Form PR008 Rev. 1/1/15 ORDER APPOINTING COUNSEL Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com