Form 17.7 - Guardian'S Report - Ohio Page 2
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2[Reverse of Form 17.7]
5.
Guardian's contact with the ward.
a.
Approximate number of times the guardian had contact with the ward during the period covered by this
report: _________________
b.
The nature of those contacts (phone, personal, or other): ______________________________________
____________________________________________________________________________________
c.
Date the ward was last seen by the guardian: ________________________________________________
6.
Have you observed any major change in the ward's physical or mental condition during the period covered
by this report?
Yes
No
If "yes" is checked, briefly describe the changes. ___________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
7.
The care giver to the ward is
Adequate
Not Adequate
If "Not Adequate" is checked, explain. ___________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
8.
The guardianship should be
Continued
Not Continued
If "Not Continued" is checked, explain. ___________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
9.
During the period covered by this report, the ward
has
has not been seen by a physician. If the ward has been
seen, the last date was _______________________________________________ and for the purpose of
___________________________________________________________________________________________
Attached is a statement by a licensed physician, a licensed clinical psychologist, a licensed social worker, or a mental retardation
team, that has evaluated or examined the ward within three months prior to the date of this report regarding the need for continuing
the guardianship. [R.C. 2111.49(A)(1)(I)](Form 17.1)
If an attorney has been consulted on this report:
Date _______________________________________
_________________________________________
____________________________________________
Attorney's Signature
Guardian's Signature
_________________________________________
____________________________________________
(Type or Print Attorney's Name)
(Type or Print Guardian's Name)
_________________________________________
____________________________________________
(Street)
(Street)
_________________________________________
____________________________________________
(City, State, Zip Code)
(City, State, Zip Code)
(______)________________ _________________
(______)_____________________________________
Telephone Number
Supreme Court Registration No.
Telephone Number
(Knowingly giving false information on a Probate document is a criminal offense)
[R.C. 2921.13(A)(11)]
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