IN THE CIRCUIT COURT FOR ORANGE COUNTY, FLORIDA PROBATE/ MENTAL HEALTH DIVISION IN RE: GUARDIANSHIP OF File No. 48- ANNUAL GUARDIANSHIP REPORT ANNUAL GUARDIANSHIP PLAN OF GUARDIAN OF PERSON (Adult Ward) , the guardian of the person of (the Ward), submits the following plan as the Annual Guardianship Report of this guardian: The Annual Guardianship Plan for the period beginning , and ending 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): , _, shall be as follows: , 3. The current residential setting (circle one) 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: American LegalNet, Inc. www.FormsWorkflow.com 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: 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: American LegalNet, Inc. www.FormsWorkflow.com C. Describe the Ward's activities at communication and visitation: D. Description of the social needs of the Ward: 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. American LegalNet, Inc. www.FormsWorkflow.com 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 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 FOR ORANGE COUNTY, FLORIDA PROBATE/ MENTAL HEALTH DIVISION IN RE: GUARDIANSHIP OF File No. 48- PHYSICIAN'S REPORT 1. Name of Physician: Address: 2. Name of ward: 3. Date of examination: 4. Purpose of examination: a. Regular checkup b. Treatment for 5. Evaluation of ward's condition: (Specify mental and physical condition at time of exam) 6. Description of ward's capacity to live independently: 7. The ward (circle one) does or does not continue to need assistance of a guardian. American LegalNet, Inc. www.FormsWorkflow.com 8. Is the ward capable of being restored to capacity at this time? (circle one) Yes or No 9. Date of this report: 10. Signature of physician completing this report: American LegalNet, Inc. www.FormsWorkflow.com