PROBATE COURT OF COUNTY, OHIO IN THE MATTER OF THE GUARDIANSHIP OF CASE NO. INVESTIGATOR'S REPORT (R.C. 2111.041) GENERAL INFORMATION [To be completed by counsel/applicant] Prospective ward's age Residence Relationship to applicant If guardianship is limited, include specific duties requested: Grounds for application (R.C. 2111.01 (D)) Documentation submitted and date of evaluation INVESTIGATOR'S REPORT [To be completed by Probate Court Investigator] Service of notice made in hospital, nursing facility, or community based care facility: Name of Facility Address of Facility Administrator or representative served Prospective ward's understanding of the concept of guardianship: Good Fair Poor Unable to Determine Prospective ward's attitude of the concept of guardianship was: Consenting Opposed Unable to Determine Specific requests of prospective ward concerning enumerated rights: Others present during contact: FORM 17.8 - INVESTIGATOR'S REPORT 9/1/91 American LegalNet, Inc. www.FormsWorkflow.com CASE NO. Describe the extent to which the prospective ward's rights were communicated and the method and language used. MENTAL AND PHYSICAL CONDITION OF PROSPECTIVE WARD Observed or reported evidence of mental and/or physical impairments affecting prospective ward's ability to properly care for himself. a) mental b) physical RECOMMENDATIONS Is there a necessity for guardianship? Yes No Describe: Is there evidence that a less restrictive alternative is needed? Yes No Describe: Necessity for appointment of: Attorney Independent Expert Evaluator Special urgency needs (describe) Remarks Date Investigator FORM 17.8 - INVESTIGATOR'S REPORT American LegalNet, Inc. www.FormsWorkflow.com