FORM MH-105 GC order apptg ER temp with notice

• Legal Form Number: FORM MH-105
• Date: 01 January 2014
• Section: Az Mh Forms Annotated

FORM MH-105

[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. __________ ORDER APPOINTING TEMPORARY [LIMITED] GUARDIAN WITH MENTAL HEALTH POWERS AND CONSERVATOR FOR AN ADULT (WITH NOTICE) Hearing on __________at __________

Warning: This appointment is not effective until the “Letters of Appointment” have been issued by the Clerk of the Superior Court.

Having considered the Petition for Emergency Appointment of Temporary Guardian of and Conservator for an Adult (with Notice) and the evidence presented, the Court finds:

1. Petitioner, __________, is entitled to file the Petition pursuant to A.R.S. §§ 14-5303 and -5404.

2. Venue in this county is proper.

3. Notice was given as required by law or as otherwise directed by the court.

4. [Ward’s name] [currently has no guardian and an emergency exists] [has a guardian who is not effectively performing the duties of a guardian and the ward’s welfare requires immediate action].

5. [(Protected person’s name) currently has no conservator and an emergency exists] [Conservator _________ was appointed as conservator for (protected person name) but Conservator is not effectively performing [his] [her] duties and the estate and affairs of (protected person’s name) requires immediate action].

6. By clear and convincing evidence, [ward’s name] is an incapacitated person as defined by A.R.S. § 14-5101(1); the appointment of a guardian [with limited powers] is necessary to provide for the ward’s demonstrated needs; and [some of] the ward’s needs cannot be met by less restrictive means including the use of appropriate technological assistance.

7. By clear and convincing evidence, the incapacity is a result of a mental disorder as defined by A.R.S. § 36-501(25) and [name of the person alleged to be incapacitated and in need of protection] is likely to be in need of inpatient mental health care and treatment within the next year, including placement in a level one behavioral health facility licensed by the Arizona Department of Health Services and the medical psychiatric and psychological treatment associated with that placement.

8. Pursuant to A.R.S. § 14-5311(B), [appointee’s name] is qualified to serve as the temporary guardian of [ward’s name] [and has priority for such appointment].

9. [The ward cannot safely operate a motor vehicle.]

10. [A limited guardianship being appropriate, the ward’s right to vote and to exercise any other civil rights are retained.]

11. Appointment of a conservator is necessary because [protected person’s name] (a) is unable to...