IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT IN AND FOR BREVARD COUNTY, FLORIDA Case No.: ____________________________ IN RE: THE GUARDIAN ADVOCACY OF ____________________________________ Name of Person with a Developmental Disability ORDER APPOINTING ATTORNEY AND ELISOR FOR THE PERSON WITH A DEVELOPMENTAL DISABILITY (Form D) This proceeding is of a kind where appointment of an attorney is either required by law or is desirable. It is therefore ORDERED that: 1. Attorney _______________________________________________, whose address is _______________________________________________________________________, is hereby appointed as Attorney for ____________________________________, a person with a developmental disability, to represent the person in all proceedings involving the Petition for Appointment of Guardian Advocate, and if there is an Appointment of Guardian Advocate, to review the initial plan and represent the person during any objections thereto. 2. The Attorney is appointed Elisor to serve on and read to the person with a developmental disability the Notice of Petition for the Appointment of Guardian Advocate and all other pleadings required to be served on and read to the person with a developmental disability at the time of the service of the Notice. 3. A copy of this Order shall serve as authorization for the Attorney to inspect any of the records relating to the person with a developmental disability maintained by the Clerk of this Court, any school, hospital, doctor, or other social or human services agency without the necessity of written consent by the parents. Any information received from such source shall be kept confidential. The Attorney shall not disclose the same except in written or oral reports to the Court or as otherwise authorized by the Court. Page 1 of 2 of Form D American LegalNet, Inc. www.FormsWorkFlow.com 4. The Petitioner shall provide the attorney named herein with copies of all pleadings, notices, and other documents filed in this action. DONE AND ORDERED this ______ day of _________________, 20___. ____________________________________ Circuit Judge CERTIFICATE OF SERVICE I do hereby certify that copies hereof have been furnished by U.S. Mail to: Attorney appointed to represent person with a developmental disability Next of kin of the person with a developmental disability, if any Health Care Surrogate designated by the person with a developmental disability pursuant to advanced directives, if any Agent appointed by the person with a developmental disability under Durable Power of Attorney, if any ________________________________ Judicial Assistant ________________________________ ________________________________ Address Date:____________________________ Page 2 of 2 of Form D American LegalNet, Inc. www.FormsWorkFlow.com