IN THE CIRCUIT COURT OF THE THIRTEENTH JUDICIAL CIRCUIT IN AND FOR HILLSBOROUGH COUNTY, STATE OF FLORIDA PROBATE, GUARDIANSHIP AND MENTAL HEALTH DIVISION IN RE: THE GUARDIANSHIP OF Case No.: Division: A Incapacitated/Ward. _________________________/ SIMPLIFIED ANNUAL PLAN The undersigned, as the Guardian(s) of the above-named Ward, report(s) to the court as follows: 1a.) The name and address of all places the ward has resided during the preceding year. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 1b.) Why is this the best placement for the ward? ________________________________________________________________ ________________________________________________________________ 2.) List all professional medical/mental health treatment the ward has received during the past year (did the ward see a doctor, dentist, or mental health professional, if so when?): _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 3.) What is the ward’s condition which causes him/her to continue to need a guardian? _______________________________________________________________ _______________________________________________________________ 4.) What personal and social services were provided for the ward in the past year (i.e., programs attended, vacations, in-home activities, out-of-the home activities, what does the ward like to do for entertainment or in his/her free time)? _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com 5.) In the past year, how has the ward interacted with others, including the guardian and family members (if the ward is not able to interact, state why)? _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 6.) Should the ward have any rights restored at this time? _______________________________________________________________ _______________________________________________________________ ____________________ Date __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ Guardian Name, Address & Phone Number DELIVERY: The original copy of this Simplified Annual Plan must be filed with the Clerk of the Circuit Court. Mailing Address: Physical Address: P.O. Box 1110, Tampa, FL 33601-1110 800 E. Twiggs St., Rm. 206, Tampa, FL 33602 (Edgecomb Courthouse – Downtown Tampa) American LegalNet, Inc. www.FormsWorkflow.com