IN THE CHANCERY COURT OF HAMILTON COUNTY, TENNESSEE IN RE THE CONSERVATORSHIP OF * , * N0. RESPONDENT * PART 1 Ex Parte * ORDER APPOINTING GUARDIAN AD LITEM AND SETTING HEARING It appearing to the COURT that [PETITIONER] has filed a verified PETITION FOR APPOINTMENT OF CONSERVATOR for (hereinafter RESPONDENT) whose Social Security Number is -- and whose date of birth of is , and pursuant to T.C.A. 247 34-1-107, it is hereby ORDERED: 1. , an attorney licensed to practice before this COURT, is appointed to be the guardian ad litem for RESPONDENT. It is the duty of the guardian ad litem to investigate and assess the physical, mental, and financial status of RESPONDENT; determine if a proposed fiduciary is the appropriate person to be appointed; review the PROPOSED PROPERTY MANAGEMENT PLAN; and provide findings in a written report. 2. The guardian ad litem is authorized access to the records of RESPONDENT in any financial institution in accordance with law, and shall be the customer within the meaning set forth in Title 45, Chapter 10, known as the Financial Records Privacy Act. 3. The guardian ad litem is authorized to review any medical records of RESPONDENT relevant to the PETITION FOR APPOINTMENT OF CONSERVATOR. 4. The guardian ad litem is hereby permitted to discuss the physical and mental conditions of RESPONDENT with any physician, psychologist or other health care provider who may have relevant information regarding the PETITION FOR APPOINTMENT OF CONSERVATOR filed herein. 5. The guardian ad litem shall have the duties and responsibilities set forth in T.C.A. 247 34-1-107 and the written report shall be filed with the CLERK & MASTER and served upon the parties not less than three (3) days prior to the hearing. 6. This matter is set for hearing on the day of , 20, at a.m. and counsel shall inform the COURT222S secretary if the hearing is anticipated to take more than fifteen (15) minutes or if the petition is contested. American LegalNet, Inc. www.FormsWorkFlow.com 7. The CLERK & MASTER, pursuant to T.C.A. 247 34-1-106, shall see to the service of a copy of the petition, summons, and this ORDER upon RESPONDENT as set forth in the PETITION FOR APPOINTMENT OF CONSERVATOR. ENTER this day of , 20. PAMELA A. FLEENOR APPROVED FOR ENTRY CHANCELLOR [ATTORNEY, BPR# ] [LRCP 3.04 INFORMATION] [Form 061, Rev. 2002.01.11] American LegalNet, Inc. www.FormsWorkFlow.com