Form Ccp 0222 A - Guardian'S Annual Report Regarding Ward
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2CCP 0222 A (Rev. 08/16/16)
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
COUNTY DEPARTMENT, PROBATE DIVISION
File No.
Estate of
A Person with a Disability
GUARDIAN’S ANNUAL REPORT REGARDING WARD
Pursuant to §11a-17(b) of the Probate Act of 1975 [755 ILCS 5/11a-17(b)],
,
[printed name of the Guardian]
having been appointed on
as guardian of the person of
[date of appointment]
(the “Ward”), submits this annual Report
[printed name of the a person with a disability]
as follows (if the Ward is deceased, attach a copy of the death certificate and do not complete the numbered paragraphs
of this Report):
1.
The Ward is now ________ years of age.
The Ward’s current mental diagnosis: ________________________________________________________________
The Ward’s current physical diagnosis: _______________________________________________________________
The Ward’s current mental condition: ________________________________________________________________
The Ward’s current physical condition: _______________________________________________________________
The Ward’s current social condition: ________________________________________________________________
2.
The Ward’s current living arrangements, including the place of residence, and the Guardian’s opinion as to the
appropriateness of those arrangements: ______________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
The Ward’s other places of residence since the last report and the length of stay at each place:
Address of Other Place of Residence
Length of Stay
__________________________________________________________
________________________________
__________________________________________________________
________________________________
__________________________________________________________
________________________________
3. Medical and dental services provided to the Ward: ______________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Educational service provided to the Ward:
______________________________________________________________________________________________
Vocational and other professional services provided to the Ward: __________________________________________
______________________________________________________________________________________________
DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
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