SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION _________ INT _________ _________ IDD _________ In re: ________________________________ An Adult ORDER APPOINTING COUNSEL (Subject outside the metropolitan area) Upon consideration of the petition filed herein on the ______ day of ________________, 20______, it is by the Court this ____ day of ______________________, 20______, ORDERED that _____________________________ is appointed counsel for _________________________________, the subject of the above proceeding. The counsel shall have access to any current medical, psychological, or sociological evaluation records of the subject. Counsel shall perform the duties set forth in D.C. Code, sec. 21-2033(b) and Superior Court, Probate Division Rule 305. However, because the subject is outside the metropolitan area, the personal Counsel shall represent the subject at the hearing to be held interview that counsel must have with the subject may be accomplished via some form of teleconference. on__________________, 20______, at __________ o'clock a.m./p.m. in Courtroom _____ of the Superior Court of the District of Columbia, Building A, 515 5th Street, NW, Washington, DC, before Judge ___________________________________________________, and it is further ORDERED that counsel shall forthwith file a Notice of Appearance pursuant to Superior Court, Probate Division Rules 321(d) and 305(a)(2). _______________________________________ JUDGE cc: March 2012 � 917.10.v2 American LegalNet, Inc. www.FormsWorkFlow.com