Georgia Advanced Directive Page 26
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29PART THREE: GUARDIANSHIP
(10) GUARDIANSHIP
[PART THREE is optional. This advance directive for health care will be
effective even if PART THREE is left blank. If you wish to nominate a
person to be your guardian in the event a court decides that a guardian
should be appointed, complete PART THREE. A court will appoint a
guardian for you if the court finds that you are not able to make significant
responsible decisions for yourself regarding your personal support, safety,
or welfare. A court will appoint the person nominated by you if the court
finds that the appointment will serve your best interest and welfare. If you
have selected a health care agent in PART ONE, you may (but are not
required to) nominate the same person to be your guardian. If your health
care agent and guardian are not the same person, your health care agent
will have priority over your guardian in making your health care decisions,
unless a court determines otherwise.]
[State your preference by initialing (A) or (B). Choose (A) only if you have
also completed PART ONE.]
(A) __________ (Initials) I nominate the person serving as my health care
agent under PART ONE to serve as my guardian.
OR
(B) __________ (Initials) I nominate the following person to serve as my
guardian:
Name: ___________________________________________________________
Address: _________________________________________________________
_________________________________________________________________
_________________________________________________________________
Telephone Numbers: ________________________________________________
_________________________________________________________________
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