Supplement For Emergency Guardian Of Person (Cuyahoga) {17.1a}

FORM 17.1A - SUPPLEMENT FOR EMERGENCY GUARDIAN OF PERSON [R.C. 2111.02(B)(3)]. This form is used in the Probate Court of Cuyahoga County, Ohio, when a request is made for an emergency guardianship for an individual. It is required under R.C. 2111.02(B)(3) and must be completed alongside the Statement of Expert Evaluation (Form 17.1). This form addresses several aspects of the emergency situation. It asks whether the individual has a durable health care power of attorney and, if so, why it is not being honored. The form also requires a description of the exact nature of the emergency, the length of time the emergency has existed, and the reasons behind it. It asks for specific actions needed to prevent significant injury to the person, as well as the ability of the alleged incompetent individual to receive notice and give consent. Additionally, the form requires a detailed medical prognosis if immediate action is not taken within 24 hours. The form may also include additional statements regarding the individual’s condition, family, and support services. The form must be signed by a licensed physician, and the date and time of the evaluation should be provided. This form is necessary to establish the need for emergency guardianship to ensure the immediate well-being of the individual involved. www.FormsWorkflow.com