IN THE EIGHTH JUDICIAL CIRCUIT COURT IN AND FOR _________________ COUNTY, FLORIDA IN RE: GUARDIANSHIP/GUARDIAN ADVOCACY OF _______________________________________ Case No: _____________________ GUARDIANSHIP DIVISION ANNUAL GUARDIANSHIP / GUARDIAN ADVOCACY PLAN I, __________________________________________________________________, the Guardian / Guardian Advocate of the person of ____________________________________________________________ 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 this plan is __________________________________________________________________ __________________________________________________________________ 2. During the preceding year, the Ward resided at (include dates, names, addresses and length of stay at each place): submits the American LegalNet, Inc. www.FormsWorkFlow.com 3. The current residential setting (circle on) is or is not best suited for the current needs of the Ward. 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. Description of professional medical treatment given to the Ward during the preceding year: PHYSICIAN TREATMENT DATE _______________________________ 6. Report of a physician who examined the Ward no more than 90 days before the beginning of the report period is attached. Report contains an evaluation of the Ward's condition and a statement of the current level of capacity of the Ward. 7. Plan for provision of medical, mental health and rehabilitative services in the coming year is as follows: American LegalNet, Inc. www.FormsWorkFlow.com 8. Information concerning the social condition of the Ward is submitted as follows: A. The social and personal services currently utilized by the Ward are: B. State the social skills of the Ward, including how well the Ward maintains interpersonal relationships with others: C. Describe the Ward's activities at communication and visitation: D. Description of the social needs of the Ward: American LegalNet, Inc. www.FormsWorkFlow.com 9. Summary of activities during the preceding year designed to increase the capacity of the Ward: 10. The Ward (circle one that applies) is or is not capable of having some or all of his/her rights restored. If capable, identify rights that should be restored 11. I/We (circle one) do or do not plan to seek the restoration of any rights to the Ward. 12. This plan (circle one) has or 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 the ______ day of ____________________________ _____________________________________________________________ Attorney for Guardian (If applicable) Florida Bar No.________________________________________________ _____________________________________________________________ Signature of Guardian _____________________________________________________________ Signature of Co-Guardian _____________________________________________________________ Address _____________________________________________________________ Signature of Ward (If applicable) American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT OF THE EIGHTH JUDICIAL CIRCUIT, _________________ COUNTY, FLORIDA IN RE: GUARDIANSHIP / GUARDIAN ADVOCACY OF ________________________________, Ward. CASE NO. ________________________ ________________________________________________________________________ PHYSICIAN'S REPORT (adult ward) Reference: Florida Statute 744.3675 1. Physician's Name:_____________________________________________________ 2. Physician's Address ________________________________________________________________________ _________________________________________________________________ 3. Report of Examination of Ward: A. Examination Date_______________________________________________ B. Purpose of Examination: ______Routine checkup ______Treatment for______________________________________________________ _______________________________________________________________________ 4. The ward's mental and physical condition at time of the examination is: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ 5. Description of ward's capacity to live independently: _________________________ _______________________________________________________________________ _______________________________________________________________________ 6. The ward (does) (does not) continue to need assistance of a guardian. 7. Is the ward capable of being restored to capacity at this time? (Yes) (No) 8. Signature of Physician _______________________Report date: ____________20____ American LegalNet, Inc. www.FormsWorkFlow.com