Guardian'S Report - Oregon Circuit Court printable pdf download

IN THE CIRCUIT COURT OF THE STATE OF OREGON

THIRD JUDICIAL DISTRICT

Probate Department

In the Matter of the (co-)Guardianship of:

)

Case No._________________

)

______________________________________

)

GUARDIAN’S REPORT

A Minor, Protected Person.

)

I am (We are) the guardian(s) for the person named above, and I make the following report to the

court as required by law:

My/our name(s) is:__________________________________________________________

My/our address is:__________________________________________________________

My /our telephone is:___________________

The name, if applicable, and address of the place where the person now resides are:________

___________________________________________________________________________

The person is currently residing at the following type of facility or residence:_____________

___________________________________________________________________________

The person is currently engaged in the following programs and activities and receiving the

following services (brief description):____________________________________________

__________________________________________________________________________

I was (We were) paid for providing the following items of lodging, food or other services to

the person:

__________________________________________________________________________

The name of the person primarily responsible for the care of the person at the person’s place

of residence is:_______________________________________________________________

The name and address of any hospital or other institution where the person is now admitted

on a temporary or permanent basis are:___________________________________________

___________________________________________________________________________

The person’s physical condition is as follows:______________________________________

___________________________________________________________________________

10.

The person’s mental condition is as follows:_______________________________________

___________________________________________________________________________

11.

I/We made the following contacts with the person during the past year (brief description):

_____________________________________________________________________

GUARDIAN’S REPORT - Page 1 of 2

FC (9/26/12)

Guardian'S Report - Oregon Circuit Court