Addendum To Petition For Guardianship Of An Adult - Requesting Immediate Temporary Guardianship {E}

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Code: (Your name) _____________________________ (Your address)_____________________________ _____________________________ (Telephone) _____________________________ In Proper Person IN THE ______ JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF _____________ In the Matter of the Guardianship of the person, the estate, the person and estate. ) ) ) ) ) ______________________________, ) An Adult. ) _________________________________________) CASE NO. _____________ DEPT. NO: _____________ ADDENDUM TO PETITION FOR GUARDIANSHIP OF AN ADULT REQUESTING IMMEDIATE TEMPORARY GUARDIANSHIP _________________________________and_____________________________________ (Name of Petitioner) (Name of Co-Petitioner) Petitioner(s) in this matter, state(s) as follows: 1. A Verified Petition For Guardianship was filed in this matter on (Date Petition was filed)_____________________________by the above-named Petitioner(s) to be appointed guardian(s) of (Name of Ward) _________________________________________ 2. reasons: One of the following questions, A or B, must be answered with a "yes" in order for an I immediate guardianship to be considered. Both A and B may apply. If so, answer "yes" on both A and B lines. Carefully, and in detail, explain your answers to the statements. A. _______ The Ward faces a substantial risk of immediate physical harm or needs immediate medical attention and the Ward lacks the capacity to respond to the risk of harm or to Adult Addendum/Temporary Addendum to Petition 1 of 7 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com This Request For Immediate Temporary Guardianship is made for the following 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 obtain the necessary medical attention because: _____________________________________________________________________________ ____________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ____________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ _____________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ (If you need more space, you may attach additional pages. Be sure the pages clearly indicate they are a continuation of this portion of the document.) B. _______ The Ward is unable to respond to a substantial and immediate risk of financial loss and the Ward lacks the capacity to respond to the risk of loss because: ___________________________________________________________________________ ____________________________________________________________________________ __________________________________________________________________________ Adult Addendum/Temporary Addendum to Petition 2 of 7 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ____________________________________________________________________________ _____________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ (If you need more space, you may attach additional pages. Be sure the pages clearly indicate they are a continuation of this portion of the document.) 3. I have filed a certificate signed by a physician licensed to practice in this state which states that the proposed Ward is unable to respond to a substantial and immediate risk of physical harm, or, the Ward is in need of immediate medical attention, or, the Ward faces a substantial risk of financial loss, and the Ward lacks capacity to respond to those risks, or, I have filed an Affidavit explaining why the certificate is not available at this time. 4. I (have or have not) ______________ tried in good faith to notify the following people of this Request For Immediate Guardianship: Carefully read the following statements and print "yes" or "no" to each statement. ________ Husband or Wife of the Ward on ________________________. (yes or no) (date contact was made) In person By telephone In writing ________ Children of the Ward on _____________________________. (yes or no) (date contact was made) In person By telephone In writing Adult Addendum/Temporary Addendum to Petition 3 of 7 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ________ Parents of the Ward on _____________________________ (yes or no) (date contact was made) In person By telephone In writing _______ Current Legal Guardian of the Ward on ____________________ (yes or no) (date contact was made) In person By telephone In writing ________ Brothers and/or Sisters of the Ward who are over the age of 14 years on (yes or no) ________________________ (date contact was made) In person By telephone In writing ________ Current Legal Guardians of any brothers and sisters of the Ward who are under the (yes or no) age of 14 years on ___________________ (date contact was made) In person By telephone In writing ________ The current person or officer of a care provider having the care, custody or control (yes or no) of the Ward on ___________________ (date contact was made) In person By telephone In writing ________ The Ward has no spouse and there are no know