Guardianship Intake Form printable pdf download

Guardianship Intake Form

Please answer the following questions in order to provide information required to

pursue Guardianship. Please let us know if you are unsure of any of your responses.

Today’s Date _______________

Your name

______________________________________________________________

Your address and phone number

_____________________________________________

___________________________________________________________________

_____

How were you referred to this office?

_________________________________________

Name and permanent address of the proposed Ward

______________________________

___________________________________________________________________

_____

Current address of the proposed Ward

_________________________________________

Your relationship to the proposed Ward

_______________________________________

The proposed Ward’s date of birth

___________________________________________

The proposed Ward’s social security number

___________________________________

Has anyone pursued guardianship or conservatorship of the proposed ward before?

_____

Is the proposed Ward married?

______________________________________________

Does the proposed Ward have any children?

____________________________________

Does the proposed Ward have any living parents?

_______________________________

Please list the next of kin of the proposed Ward, including their addresses and their

relationship to the proposed Ward

Guardianship Intake Form