1 IN THE COURT OF CHANCERY OF THE STATE OF DELAWARE IN THE MATTER O F: , a p erson with a disability : : : : C.M. # ORDER APPOINTING ATTORNEY AD LITEM WHEREAS, the Court having considered the petition to terminate guardianship due to the recovery of the disabled person ; IT IS HEREBY ORDERED, this day of , , as follows: 1) , Esquire is hereby appointed attorney ad litem on behalf of the p erson with a disability . 2) The attorney ad litem shall investigate the sta tements of the physician as they relate to the guardianship being terminated due to recovery. The attorney ad litem shall determine whether in his/ her opinion , the p erson with a disability is capable of making her own medical and financial decisions. 3) All p hysicians, hospitals and other healthcare providers covered under the Privacy Standards of the Health Insurance Portability and Accountability Act (HIPAA) are authorized to disclose to the attorney ad litem and shall provide the attorney ad litem unobstruc ted access to all medical records, treatment providers, clinical information and other healthcare information relating to the current mental American LegalNet, Inc. www.FormsWorkFlow.com 2 and physical health of the p erson with a disability that the attorney ad litem deems necessary for the proper disch arge of his/ her duties. 4) All said physicians, hospitals and other healthcare providers shall grant the access described above to the attorney ad litem without delay. 5) The attorney ad litem is hereby authorized to review all necessary documents concerning the gua rdianship case. Furthermore, the attorney ad litem shall have the authority to meet with the guardian ( s ) and the p erson with a disability to discuss all aspects of this guardianship case. 6) The attorney ad litem shall submit his/ h er report to the Register i n within twenty (20) days of the date of this order . Chancellor/Vice Chancellor/Master American LegalNet, Inc. www.FormsWorkFlow.com