PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN THE MATTER OF THE GUARDIANSHIP OF __________________________________ CASE NUMBER _______________________________ Date ____________________ BIENNIAL REPORT OF GUARDIAN 1) State present residence address of ward: _____________________________________ _________________________________________________________________________________ . 2) State the type and the name, if any, of the home or facility where the ward lives: __________________________________________________________________________________ and the name of the person in charge of the home: _________________________________________ . 3) State your present residence address: ________________________________________ _________________________________________________________________________________ . 4) During the last year, how many times have you seen the ward? ____________________ What was the date when you last saw the ward? __________________________________________ . State the nature of your visits: __________________________________________________________ __________________________________________________________________________________ _________________________________________________________________________________ . 5) Is there a plan for the ward’s care, training or treatment? ________________________ . If so, do you agree with its provisions? _______________ . If not, explain what you disagree with: __________________________________________________________________________________ __________________________________________________________________________________ _________________________________________________________________________________ . (OVER) American LegalNet, Inc. www.FormsWorkflow.com 6) When was the ward last seen by a physician? ________________________________ . What was the purpose of the visit? ______________________________________________________ _________________________________________________________________________________ . __________________________________________________________________________________ 7) Have you observed any major changes in the Ward’s physical or mental condition during the last year? ___________ . If so, state your observations: _______________ __________________________________________________________________________________ _________________________________________________________________________________ . 8) In your opinion, should this guardianship be continued? ________________________ . If no, why not ______________________________________________________________________ __________________________________________________________________________________ _________________________________________________________________________________ . 9) What is your opinion of the present care being provided to the ward and the necessity for additional care: _____________________________________________________ __________________________________________________________________________________ _________________________________________________________________________________ . The undersigned affirms that the answers set forth above are true and correct to the best knowledge and belief of the undersigned. Date: _______________________________ Signed: _____________________________ Guardian of _______________________________________ Address: _______________________________________ City: _____________________________ State ________________ Zip Code ____________ Telephone Number _______________________ American LegalNet, Inc. www.FormsWorkflow.com