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.: ___-CP-_______ Division: ________ 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? _______________________________________________________________ _______________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com 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)? _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 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's Signature __________________________________ __________________________________ __________________________________ __________________________________ Guardian Name, Address & Phone No. Email Address: ______________________ 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., Tampa, FL 33602 (Edgecomb Courthouse ­ Downtown Tampa) American LegalNet, Inc. www.FormsWorkFlow.com