IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF File No. Division COUNTY, PROBATE DIVISION ANNUAL GUARDIANSHIP PLAN (GUARDIANSHIP REPORT) OF GUARDIAN OF PERSON (Adult Ward) , the guardian of the person of (the Ward), submits the following plan as the Annual Guardianship Report of this guardian: The Annual Guardianship Plan for the period beginning __________________,________, and ending __________________,______, shall be as follows: 1. The Ward's address at the time of filing the plan is ______________________________ . 2. During the preceding year, the Ward was maintained at (include dates, names, addresses and length of stay at each place): 3. The current residential setting is is not best suited for the current needs of the Ward. Bar Form No. G-4.020 - 1 of 4 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 4. Plans for ensuring that the Ward is in the best residential setting to meet the Ward's needs during the coming year are as follows: 5. The following is a description of the Ward's medical, mental health and rehabilitation needs: 6. preceding year: The following is a description of professional medical treatment given to the Ward during the NAME OF PHYSICIAN TREATMENT DATE 7. Attached is a report of a physician who examined the Ward no more than 90 days before the beginning of the report period, containing an evaluation of the Ward's condition and a statement of the current level of capacity of the Ward. Bar Form No. G-4.020 - 2 of 4 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 8. as follows: The plan for providing medical, mental health and rehabilitative services in the coming year is 9. The following information is submitted concerning the social condition of the Ward: a. The social and personal services currently used by the Ward are as follows: b. The following is a statement of the social skills of the Ward, including how well the Ward communicates and maintains interpersonal relationships: c. The following is a description of the social needs of the Ward: 10. The following is a summary of activities during the preceding year that were designed to enhance the capacity of the Ward: Bar Form No. G-4.020 - 3 of 4 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 11. The Ward is is not capable of having some or all of the Ward's rights restored. If so, the rights that should be restored are identified as follows: 12. I do do not plan to seek the restoration of any rights to the Ward. 13. This plan has has not been reviewed with the Ward to the extent possible. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. Signed on this day of , . Guardian Attorney for Guardian Email Addresses: _______________________________________ _______________________________________ Florida Bar No. (address) Telephone: [Print or Type Names Under All Signature Lines] Bar Form No. G-4.020 - 4 of 4 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com