In The Probate Division, Circuit Court, St - St. Louis County
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1
2IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI
No.
u
In the matter of
U
Incapacitated/Disabled Person
GUARDIAN’S ANNUAL REPORT
I/We,
,
Guardian/Co-Guardians of the above named ward submit the following information as required pursuant to the
provisions of 475.082 R.S. Mo
1985.u
The present address of the ward is
.u
My/Our present address is
.u
During the past year I/We contacted the ward
times.
The nature and description of my/our contacts with the ward
–u
u
.u
Date I/we last saw the ward was
.u
The ward is currently institutionalized in
u
_____________________________________________________________. (If not institutionalized, so state.)
As Guardian/Co-Guardians have you received a copy of the treatment or rehabilitation plan?
Yes _____ No _____.
Do you agree with its provisions? Yes _____ No _____.
The date the ward was last seen by a physician is
. The purpose of the
visit by a physician was –
.u
I/We have observed the following major physical or mental conditions of the ward (if none, so state):
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
For Court’s Use Only:
KSTAT – Status/Annl Report Filing
KOSTR – Order Approving Status Report
CCPR003-WSA Rev. 05/15
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