IN THE CIRCUIT COURT OF THE IN AND FOR ,) Petitioner, ) -vs- JUDICIAL CIRCUIT COUNTY, FLORIDA DIVISION ) ) ) ) , Respondent(s). ) ) Case No. FINAL ORDER GRANTING PETITION FOR JUDICIAL WAIVER OF PARENTAL NOTICE OF TERMINATION OF PREGNANCY THIS CAUSE having come before the court on a petition for judicial waiver of parental notice of termination of pregnancy and the court being otherwise advised in the premises, finds the following: The minor has proven by clear and convincing evidence that she is sufficiently mature to decide whether to terminate her pregnancy, for the following reason(s): The court has considered the following factors in reaching this decision that the minor is sufficiently mature to decide whether to terminate her pregnancy and makes the following findings: The minor's age is . . . . . The minor's overall intelligence indicates The minor's emotional development and stability indicates The minor's credibility and demeanor as a witness indicates The minor's ability to accept responsibility is demonstrated by The minor's ability to assess both the immediate and long-range consequences of the minor's choices is demonstrated by . The minor's ability to understand and explain the medical risks of terminating her pregnancy and to apply that understanding to her decision is indicated by . Whether there may be any undue influence by another on the minor's decision to have an abortion . The minor has proven by a preponderance of the evidence that she is a victim of child abuse or sexual abuse by one or both of her parents or a guardian, for the following reason(s): The court, having made a finding under this section, will report the abuse as is required by section 39.201, Final Order Granting Petition for Judicial Waiver of Parental Notice of Termination of Pregnancy {8.990} Revision effective 10/20/11 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Florida Statutes. The minor has proven by a preponderance of the evidence that notification of a parent or guardian is not in the best interest of the minor, for the following reason(s): THEREFORE, it is ORDERED AND ADJUDGED that: 1. The petition for judicial waiver of parental notice of termination of pregnancy is GRANTED. 2. The minor may consent to the performance or inducement of a termination of pregnancy without notice to a parent or guardian. 3. The clerk shall keep and maintain a confidential record of these proceedings as provided by Florida Statutes § 390.01116, and shall seal the record. DONE AND ORDERED in the Court in and for County, Florida, on , 20 . Judge Final Order Granting Petition for Judicial Waiver of Parental Notice of Termination of Pregnancy {8.990} Revision effective 10/20/11 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com