Form 17.7 - Guardian'S Report Form Page 2
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1
2[Reverse of Form 17.7]
CASE NO.___________________
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 given 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 ____________________________________________________________________
10.
I currently serve as the guardian to ten or more wards and certify to the Court that I am unaware of
any circumstances that may disqualify me from serving as guardian for this ward.
11.
With regard to the continuing education requirement pursuant to Sup.R. 66.07:
I have completed the continuing education requirement.
(Attach Certificate of Completion if applicable)
The continuing education requirement was waived.
Attached is a statement by a licensed physician, a licensed clinical psychologist, a licensed social worker, or a
developmental disability 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 for Guardian
Guardian's Printed Name
_____________________________________
____________________________________________
Street
Guardian's Signature
_____________________________________
___________________________________________
City
State
Zip Code
Street
_____________________________________
____________________________________________
Telephone Number (include area code)
City
State
Zip Code
_____________________________________
____________________________________________
Attorney Registration No.
Telephone Number (include area code)
(Knowingly giving false information on a Probate document is a criminal offense)
[R.C. 2921.13(A)(11)]
Print Form
FORM 17.7 - GUARDIAN'S REPORT
PAGE 2
Amended: March 1, 2017
Discard all previous versions of this form
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Parent category: Legal