IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF File No. Division COUNTY, PROBATE DIVISION ORDER APPOINTING PLENARY GUARDIAN OF PERSON (Total Incapacity ­ Advance Directive) On the petition of appointment of a plenary guardian of the person of for the (the Ward), the Court finding that the Ward is totally incapacitated as adjudicated by order of this Court entered the person of the Ward, it is ADJUDGED as follows: 1. is hereby appointed plenary guardian of the person of 2. is qualified to serve and . , , and that it is necessary for a plenary guardian to be appointed for Upon taking the prescribed oath and filing a designation of resident agent and acceptance, letters of guardianship shall be issued. 4. The court finds that the Ward, prior to incapacity, appointed a health care surrogate pursuant to Florida Statutes Chapter 765. Such advance directive: (___) is superseded and the guardian shall exercise all delegable rights otherwise assigned to the health care surrogate. (___) shall remain in effect until further order of this court. (___) shall remain in effect to the following extent: ORDERED on ______ , . . Circuit Judge Bar Form No. G-3.065 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com