FORM MH-102 Gc Letters Temp

• Legal Form Number: FORM MH-102
• Date: 01 January 2022
• Section: AZ MH Forms Annotated

FORM MH-102

(Attorney's name, State Bar No.)

(Attorney's law firm name)

(Law firm bar number)

(Address)

(Phone number)

(Attorney or firm's e-mail address)

Attorney for: __________

SUPERIOR COURT OF ARIZONA, __________ COUNTY

In the Matter of the Guardianship of and Conservatorship for: an Adult. No. __________ LETTERS OF Temporary Guardian WITH MENTAL HEALTH POWERS and CONSERVATOR

1. (Appointee's name) is appointed temporary guardian of (subject person's name) and granted the general powers of a guardian pursuant to A.R.S. §§ 14-5312, -5312.01 and -5312.01(B), including but not limited to the power to consent for (subject person's name) to receive inpatient mental health care and treatment and be placed in a level one behavioral health facility licensed by the Arizona Department of Health Services for medical, psychiatric, and psychological treatment, subject to the following restrictions: .

2. __________ is appointed temporary conservator for (subject person's name) and is granted the general powers of a conservator pursuant to A.R.S. §§ 14-5424 and -5425.

3. This temporary appointment and the authority to consent to inpatient mental health care...