FORM MH-121 Gd Letters and Acceptance

• Legal Form Number: FORM MH-121
• Date: 01 January 2022
• Section: AZ MH Forms Annotated

FORM MH-121

(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. __________ LETTERS OF GUARDIAN AND ACCEPTANCE OF APPOINTMENT WITH MENTAL HEALTH POWERS

LETTERS OF GUARDIAN

1. __________ is appointed guardian of (subject person's name) and granted the general powers of a guardian pursuant to A.R.S. §§ 14-5312 and -5312.01, 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. Unless modified by subsequent court order, Guardian's authority to consent to inpatient mental health care and treatment shall expire on __________. The expiration of these mental health powers shall not terminate Guardian's appointment as guardian and...