FORM MH-119 Gd Adult Order Apptg

• Legal Form Number: FORM MH-119
• Date: 01 January 2024
• Section: Az Mh Forms Annotated

FORM MH-119

(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: an Adult. NO. __________ ORDER APPOINTING GUARDIAN [WITH LIMITED POWERS AND] WITH MENTAL HEALTH POWERS Hearing on __________ at __________

Warning: This appointment is not effective until the Clerk of the Superior Court issues the letters of appointment.

Having considered the Petition for Appointment of Guardian and the evidence presented, the Court finds:

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

2. The Court has jurisdiction, and venue in this county is proper.

3. Notice was given as required by law.

4. By clear and convincing evidence, (a) (subject person's name) is an incapacitated person as defined by A.R.S. § 14-5101(3), (b) the appointment of a guardian [with limited powers] is necessary to provide for (subject person's name)'s demonstrated needs, and (c) [some of] [his] [her] [their] needs cannot be met by less restrictive means including the use of appropriate technological assistance.

5. By clear and convincing evidence, the incapacity is a result of a mental disorder as defined by A.R.S. § 36-501(25) and (subject person's name) is likely to need 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.

6. Pursuant to A.R.S. § 14-5311(B), __________ [has priority for appointment and] is qualified to serve as the guardian of (subject person's name).

[7. (Subject person's name) cannot safely operate a vehicle.]

[8. A limited guardianship being appropriate, (subject person's name)'s right to vote and to exercise any other civil rights are retained.]

9. Bond is [not required] [required in the amount of __________].

IT IS ORDERED:

A. Appointing __________ as the guardian of (subject person's name) [with all of the powers set forth in A.R.S. §§ 14-5312 and -5312.01(A), including but not limited to the power to consent for (subject person's name) to receive psychiatric and psychological care and treatment so long as it takes place outside a level one behavioral health facility licensed by the Arizona Department of Health Services] [with limited powers as defined in paragraph U below, including but not limited to the power to consent for (subject person's name) to receive psychiatric and psychological care and treatment so long as it takes place outside a level one behavioral health facility licensed by the Arizona Department of Health Services].

B. Guardian has the authority, pursuant to A.R.S. §§ 14-5312 and -5312.01(B) to consent for (subject person's name) to receive inpatient mental health care and treatment, including placement in a level one behavioral health facility licensed by the Arizona...