IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF COUNTY, PROBATE DIVISION File No. Division INITIAL GUARDIANSHIP PLAN (GUARDIANSHIP REPORT) OF GUARDIAN OF THE PERSON (Minor Ward) , the guardian of the person of (the Ward), who presently resides at , submits the following plan as the Initial Guardianship Report of this guardian: 1. During the period beginning , a. , , and ending , the guardian proposes the following plan for the benefit of the Ward. Medical, mental or personal services to be provided for the welfare of the Ward: b. Social and personal care services to be provided for the welfare of the Ward: c. Name and location of school the Ward will attend, the Ward's grade and a description of classes the Ward will attend: d. Place and kind of residential setting best suited for the needs of the Ward: Bar Form No. G-4.010 - 1 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com e. Description of health and accident insurance and any other private or governmental benefits to which the Ward may be entitled to meet any part of the costs of medical, mental health or related services provided to the Ward: f. Physical and mental examinations necessary to determine the Ward's medical and mental health treatment needs: 2. The guardian attests that: [delete the inapplicable statement] a. b. The Ward is a minor under the age of 14, or The guardian has consulted with the Ward and, to the extent reasonable, honored the Ward's wishes consistent with the rights retained by the Ward under the plan. 3. 4. To the maximum extent reasonable, the plan is in accordance with the wishes of the Ward. This Initial Guardianship Plan does not restrict the physical liberty of the Ward more than is reasonably necessary to protect the Ward or others from serious physical injury, illness or disease and provides the Ward with care and appropriate supervision. 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-4.010 - 2 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com