Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward

There are all sorts of forms executors, beneficiaries, and probate court clerks have to fill out and correspond with during probate and estate settlement, including affidavits, letters, petitions, summons, orders, and notices.

Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward is a commonly used form within Georgia. Here’s an overview of what the form is and means, including a breakdown of the situations when (or why) you may need to use it:

Atticus Fast Facts About Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward

Sometimes it’s tough to find a quick summary— here’s the important details you should know about Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward:

• This form pertains to the State of Georgia

Government forms are not typically updated often, though when they are, it often happens rather quietly. While Atticus works hard to keep this information about Georgia’s Form GPCSF 36 - Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward up to date, certain details can change from time-to-time with little or no communication.

Step 1 - Download the correct Georgia form based on the name and ID if applicable

Double check that you have both the correct form name and the correct form ID. Some Georgia probate forms can look remarkably similar, so it’s best to double, even triple-check that you’re using the right one! Keep in mind that not all States have a standardized Form ID system for their probate forms.

Step 2 - Complete the Document

Fill out all relevant fields in Form GPCSF 36, take a break, and then review. Probate and estate settlement processes in GA are long enough to begin with, and making a silly error can push your timeline even farther back. No thank you!

Note: If you don’t currently know all of the answers and are accessing Form GPCSF 36 online, be sure to avoid closing the browser tab and potentially losing all your progress (or use a platform like Atticus to help avoid making mistakes).

Step 3 - Have Form GPCSF 36 witnessed or notarized (if required)

Some States and situations require particular forms to be notarized. If you have been instructed to get the document notarized or see it in writing on the document, then make sure to hire a local notary. There are max notary fees in the United States that are defined and set by local law. Take a look at our full guide to notary fees to make sure you aren’t overpaying or getting ripped off.

Step 4 - Submit Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward to the relevant office

This is most often the local probate court where the decedent (person who passed away) is domiciled (permanently resides) or the institution involved with this particular form (e.g. a bank). Some offices allow you to submit forms online, other’s don’t, and we while we generally recommend going in-person to expedite the process, sometimes that simply isn’t an option.

It’s also a generally good idea to establish a positive working relationship with any probate clerk (unfortunately there’s enough people & process out there making things more difficult and unnecessarily confusing for them), so a best practice is to simply ask the probate clerk proactively exactly how and where they’d prefer you to submit all forms.

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Different probate forms or processes can require different deadlines or response times for completing the appropriate form.

While some steps in the process are bound to specific deadlines (like petitioning for probate, having to submit an inventory of assets, or filing applicable notices to creditors and beneficiaries), many probate forms or processes are not tied to a specific deadline since the scope of work can vary based on situational factors or requirements involved.

Either way, there are a bunch of practical reasons why personal representatives should work to complete each step as thoroughly and quickly as possible when completing probate in Georgia.

5 reasons you should submit GPCSF 36 as quickly as possible:

1. The sooner you begin, the faster Georgia can allow heirs and beneficiaries to get their share of assets subject to probate. Acting promptly can also decrease the costs & overall mental fatigue through an otherwise burdensome process.
   
   Helpful Context: What’s the Difference Between Probate and Non-Probate Assets?

2. In general, creditors of an estate usually have around 3-6 months from the time you file notice to creditors to file any claims for debt against the deceased’s assets. If they don’t, then that debt is forfeited (and more importantly, the executor won’t be held personally responsible). So doing this sooner means you have a better idea of who is owed what and ensures you won’t get a surprise collector months later.

3. Not filing a will within 30 days (on average) could mean that the probate process proceeds according to intestate laws (laws that govern what happens to someone's stuff without a will) or is subject to unnecessary supervision by the probate court. And if you aren't directly related to the deceased (a.k.a. next of kin), this could also mean you lose your inheritance.

4. It’s important to file any necessary state tax returns on behalf of the deceased or estate by the following tax season in Georgia. If you don’t, you could owe penalties and interest. This also includes any necessary federal tax returns such as Forms 1040, 1041, or even a Form 706 estate tax return.

5. If a house in the State of Georgia is left empty (or abandoned) for a while, insurance can get dicey. For example, if the house burns down and no one has been there for a year, an insurance company may get out of paying your claim.

If you’re not using Atticus to get specific forms, deadlines, and timelines for Georgia probate, then try and stay as organized as possible, pay close attention to the dates mentioned in any correspondence you have with the State’s government officials, call the local Georgia probate clerk or court for exact answers regarding Form GPCSF 36, and when in doubt— consult a qualified trust & estates lawyer for that area.

Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward is one of the many probate court forms available for download through Atticus.

It may also be available through some Georgia probate court sites, such as . In order to access the latest version, be updated with any revisions, and get full instructions on how to complete each form, check out the Atticus Probate & Estate Settlement software or consider hiring a qualified legal expert locally within Georgia.

While Atticus automatically provides the latest forms, be sure to choose the correct version of Form GPCSF 36 - Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward f using any other site or resource in order to avoid having to re-complete the form process and/or make another trip to the Georgia probate court office.

Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward is a .pdf, so opening it should be as simple as clicking “View Form” from within the Atticus app or by clicking the appropriate link found on any Georgia-provided government platform. Once you’ve opened the form, you should be able to directly edit the form before saving or printing.

Here’s the text, verbatim, that is found on Georgia Form GPCSF 36 - Petition For The Appointment Of A Temporary Medical Consent Guardian For A Proposed Medical Consent Ward. You can use this to get an idea of the context of the form and what type of information is needed.

GPCSF 36 [i] Eff. July 2021 PETITION FOR THE APPOINTMENT OF A TEMPORARY MEDICAL CONSENT GUARDIAN FOR A PROPOSED MEDICAL CONSENT WARD INSTRUCTIONS I. Specific Instructions 1. This form is to be used in cases when, according to the provisions of O.C.G.A. § 29-4-18, a medical procedure is necessary, the proposed ward is unable to consent, and no other person, as provided in O.C.G.A. § 31-9-2, is able or willing to make the medical decisions. 2. The form must be completed so as to set forth facts which will establish probable cause to believe that the proposed medical consent ward lacks decision-making capacity and is in need of a temporary medical consent guardian, pursuant to O.C.G.A. § 29-4-18, including but not limited to (a) that the requested medical decision is necessary and why the decision is needed without undue delay; (b) that the ward is unable to make or communicate such medical decision; (c) the anticipated duration of the temporary medical consent guardianship; (d) that no other person has the authority and/or willingness to make the medical decision; and (e) whether a petition for the appointment of a guardian or conservator has been filed or will be filed as to this proposed ward. 3. According to Uniform Probate Court Rule 5.6 (A), unless the Court specifically assumes responsibility, it is the responsibility of the moving party to prepare the proper citation and deliver it properly so that it can be served according to law. All pages after the notice regarding Uniform Probate Court Rule 5.6 (A) are to be completed by the moving party, unless otherwise directed by the Court. 4. If probable cause is found by the Court, a preliminary hearing shall be held within 72 hours after the filing of the petition, notice of which shall be given to the proposed medical consent ward in accordance with O.C.G.A. § 29-4-18 (d) and, unless waived by the Court, in accordance with O.C.G.A. § 29-4-18 (e). 5. At the preliminary hearing the Court may appoint a temporary medical consent guardian, set an evidentiary hearing to be conducted no later than four days after the preliminary hearing, or dismiss the petition by issuing a court order. The forms herein allow the date for any evidentiary hearing to be determined and set in the order setting the preliminary hearing, but the decision to go forward with the evidentiary hearing would be made at the time of the preliminary hearing. If the date and time of the evidentiary hearing was not set until the preliminary hearing, a second notice shall be given to the proposed medical consent ward and may be given to any interested party according to GPCSF 36 [ii] Eff. July 2021 O.C.G.A. § 29-4-18 (e) who had not been served previously with the order setting the preliminary hearing. 6. Additional provisions are required to authorize withdrawal of life-sustaining procedures and must be specifically authorized by the Court. II. General Instructions General instructions applicable to all Georgia probate court standard forms are available in each probate court or at www.gaprobate.gov, labeled GPCSF 1. GPCSF 36 [1] Eff. July 2021 PROBATE COURT OF _______________________________ COUNTY STATE OF GEORGIA IN RE: ) ESTATE NO. ______________________ ) ____________________________________, ) PROPOSED MEDICAL CONSENT WARD ) PETITION FOR APPOINTMENT OF A TEMPORARY MEDICAL CONSENT GUARDIAN FOR A PROPOSED MEDICAL CONSENT WARD TO THE HONORABLE JUDGE OF THE PROBATE COURT: 1. Petitioner, _________________________________________________________, is the (relationship) ________________________________________________ of the proposed ward, and is domiciled at (address of petitioner) ____________________________________________ County of ___________________, State of _____________, telephone number _____________. 2. The proposed ward is _____ years of age, was born (date of birth) __________________, is domiciled at (address of ward) __________________________________________________, ________________________ County, State of ___________________, and is presently located at ___________________________________________________________, a (type of facility, if applicable) _____________________________ in _____________________ County and can be contacted at (telephone number) _______________________. [Initial if applicable] __________ It is anticipated that the proposed ward will be moved within the next three days to the following address: ___________________________________, telephone number: ___________________________. 3. The proposed medical consent ward is in need of a temporary medical consent guardian by reason of the following incapacity: _________________________________________________ to the extent that the proposed medical consent ward lacks sufficient understanding or capacity to make significant responsible decisions regarding his or her medical treatment or lacks the ability to communicate such decisions by any means. The facts which support the claim of the need for a temporary medical consent guardian are as follows: [Pursuant to O.C.G.A. § 29-4-18, the Court shall dismiss the petition if the petitioner does not GPCSF 36 [2] Eff. July 2021 allege sufficient facts to establish that the proposed medical consent ward is in need of a temporary medical consent guardian as stated above. The petition cannot be granted unless sufficient facts are presented which support the need for the appointment of a temporary medical consent guardian. While a physician’s affidavit is permissible, the petitioner MUST specifically allege sufficient facts to support the granting of this petition.] ______________________________________________________________________________ ______________________________________________________________________________ The foreseeable duration of the proposed medical consent ward’s incapacity will be: _________________________________________________. 4. The following medical decisions are needed and must be made without undue delay: [Set forth the types of treatment and/or medical procedures for which consent is needed and state why the decision(s) must be made without undue delay, that is, why the procedures for the appointment of a non-emergency (permanent) guardian are inadequate to meet the needs of the circumstances.] ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 5. It is in the best interest of the proposed medical consent ward that ___________________ be appointed as temporary medical consent guardian. Unless the proposed medical consent guardian is the petitioner, the name, address, and telephone number of the proposed medical consent guardian is ____________________________________________________________. 6. [Initial one] _______ (a) No other person has authority to act in the circumstances, whether under a power of attorney, trust, or otherwise. _______ (b) The following individual(s) with the authority to act under a power of attorney, trust, or otherwise, are absent or appear(s) unwilling or unable to act (name, address, and telephone number) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ GPCSF 36 [3] Eff. July 2021 7. [Initial one] (a) The proposed medical consent ward does have a living will or advanced directive for health care which is attached hereto and the nominated agents are listed above in subparagraph 6 (b); or (b) To the best of the petitioner’s information and belief the proposed medical consent ward does not have a living will or advanced directive for health care. 8. List all possible conflicts of interest between the proposed medical consent ward and the proposed temporary medical consent guardian including, but not limited to, being an heir of the proposed ward; or a beneficiary under his/her will, being a co-owner with the proposed ward with rights of survivorship of real property and other survivorship or beneficiary interest in bank accounts, retirement accounts, investment accounts, annuities, and life insurance policies. 9. [Initial one] A petition for permanent guardianship and/or conservatorship was/is being/will be filed in conjunction with this petition. No petition for permanent guardianship and/or conservatorship has been/will be filed. 10. Provide names, addresses, and telephone numbers for the following persons who have not joined in the petition or consented to these proceedings. Describe the relationship, if any, of these persons to the proposed medical consent ward: (1) The administrator of the hospital or health care facility where the proposed medical consent ward is located: __________________________________________________________ _____________________________________________________________________________. (2) The primary treating physician or other physicians believed to have provided any medical opinion or advice about the condition of the proposed medical consent ward relevant to the petition: __________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ . GPCSF 36 [4] Eff. July 2021 (3) All other persons the petitioner(s) believe(s) may have information concerning the expressed wishes of the proposed medical consent ward: _____________________________ _____________________________________________________________________________ . 11. Additional Data: [Where full particulars are lacking, state here the reasons for any such omission.] ___________________________________________________________________________________ ___________________________________________________________________________________ WHEREFORE, petitioner(s) pray(s): 1. that service be perfected as required by law; 2. that the Court appoint legal counsel for the proposed medical consent ward; 3. that the Court conduct a preliminary hearing within 72 hours after the filing of this petition; 4. that, if necessary, the Court order an evidentiary hearing to be conducted not later than four days after the preliminary hearing; and 5. that a temporary medical consent guardian be appointed for the proposed medical consent ward. ____________________________________ ____________________________________ Signature of First Petitioner Signature of Second Petitioner, if any ____________________________________ ____________________________________ Printed Name Printed Name ____________________________________ ____________________________________ Address Address ____________________________________ ____________________________________ ____________________________________ ____________________________________ Telephone Number Telephone Number Signature of Attorney: __________________________________________________ Typed/printed name of Attorney: __________________________________________________ Address: __________________________________________________ Telephone Number: ______________________ State Bar #__________________ GPCSF 36 [5] Eff. July 2021 VERIFICATION GEORGIA, ____________________________ COUNTY Personally appeared before me the undersigned petitioner(s) who on oath state(s) that the facts set forth in the foregoing petition are true. Sworn to and subscribed before me this _____ day of ______________, 20 ___ ___________________________________ First Petitioner ______________________________________ ___________________________________ NOTARY/CLERK OF PROBATE COURT Printed Name My Commission Expires: Sworn to and subscribed before me this _____ day of ______________, 20 ___ ___________________________________ Second Petitioner, if any ______________________________________ ___________________________________ NOTARY/CLERK OF PROBATE COURT Printed Name My Commission Expires: GPCSF 36 [6] Eff. July 2021 CONSENT TO SERVE AS TEMPORARY MEDICAL CONSENT GUARDIAN IN RE: PETITION FOR THE APPOINTMENT OF A TEMPORARY MEDICAL CONSENT GUARDIAN , A PROPOSED MEDICAL CONSENT WARD. I, _________________________________________________________, having been nominated as temporary medical consent guardian of the above-named proposed medical consent ward, do hereby consent to serve as temporary medical consent guardian, if so appointed, and do specifically agree that I am: (1) willing and able to become involved in the proposed medical consent ward’s health care decisions; and (2) willing to exercise reasonable care, diligence, and prudence, and to consent in good faith to medical or surgical treatment or procedures which the proposed medical consent ward would have wanted had he or she not been incapacitated. Where the medical consent ward’s preferences are not known, I agree to act in the proposed medical consent ward’s best interests. However, I understand that I am not authorized to withdraw life-sustaining procedures unless specifically authorized by the Court. ________________________________________ Proposed Temporary Medical Consent Guardian ________________________________________ Printed Name ________________________________________ Address ________________________________________ ________________________________________ Telephone Number GPCSF 36 [7] Eff. July 2021 NOTICE THE FOLLOWING PAGES ARE TO BE COMPLETED BY THE PETITIONER (MOVING PARTY) UNLESS OTHERWISE DIRECTED BY THE COURT. SEE UNIFORM PROBATE COURT RULE 5.6 (A). GPCSF 36 [8] Eff. July 2021 PROBATE COURT OF _______________________________ COUNTY STATE OF GEORGIA IN RE: ) ESTATE NUMBER: ) _____________________________________, ) PROPOSED MEDICAL CONSENT WARD ) ORDER FOR APPOINTMENT OF COUNSEL, APPOINTMENT OF SPECIAL PROCESS SERVER, AND NOTICE OF HEARING The above petition having been read and considered, and it appearing that there is probable cause to believe that the proposed medical consent ward lacks decision-making capacity and is in need of a medical consent guardian within the meaning of O.C.G.A. § 29-4-18. IT IS HEREBY ORDERED that ____________________________________________ is hereby appointed special agent to personally serve , proposed medical consent ward, with a copy of the petition for appointment of a temporary medical consent guardian and this order/notice. IT IS FURTHER ORDERED that a preliminary hearing shall be conducted at ____ o’clock ___.m., on _______________________ which is within 72 hours after the filing of the petition, at: ________________________________________________________________. [Initial as applicable] ______ (a) the Probate Court of _____________ County, courtroom __________, at (address) _______________________________________________________, Georgia. ______ (b) (address of location other than courthouse) ____________________________, Georgia. IT IS FURTHER ORDERED that, if an evidentiary hearing is ordered at the preliminary hearing: [Initial as applicable] the time and date for such hearing, to be held within four days after the preliminary hearing, will be set at the preliminary hearing, notice of which will be given as the Court directs. shall be held at o’clock, .m. on ____________________________, which is within four days after the date of the preliminary hearing, in courtroom _____________, _____________________ County Courthouse at (address) ______________________, Georgia. GPCSF 36 [9] Eff. July 2021 IT IS FURTHER ORDERED that the petitioner(s) and the temporary medical consent guardian(s) to be appointed, if different from the petitioner(s), attend the hearing and give testimony under oath as the Court may direct. IT IS FURTHER ORDERED that ____________________________________, attorney at law, telephone number: _________________, is hereby appointed to represent the proposed medical consent ward. NOTICE TO PROPOSED WARD: This is to notify you of a proceeding initiated in this Court by seeking to appoint a temporary medical consent guardian for you. BY THIS ORDER, THE COURT HAS APPOINTED AN ATTORNEY TO REPRESENT YOU AND HAS SCHEDULED A PRELIMINARY HEARING. YOU AND YOUR ATTORNEY HAVE THE RIGHT TO ATTEND ANY HEARING HELD ON THIS MATTER. IF A TEMPORARY MEDICAL CONSENT GUARDIAN IS APPOINTED FOR YOU, YOU MAY LOSE IMPORTANT RIGHTS TO CONTROL AND MANAGE YOUR PERSON. IT IS FURTHER ORDERED that additional service of the petition is hereby waived. IT IS FURTHER ORDERED that the clerk/deputy clerk shall serve by First-Class Mail copies of the petition and this order to all interested individuals identified in paragraph 5 or 6 of the petition, if any. IT IS FURTHER ORDERED that the clerk/deputy clerk shall serve by First-Class Mail copies of the petition and this order to the following persons: ____________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ So ordered this ____________ day of _______________________, 20_____. _____________________________________ Judge of the Probate Court GPCSF 36 [10] Eff. July 2021 CERTIFICATE OF MAILING OF ORDER FOR APPOINTMENT OF COUNSEL, APPOINTMENT OF SPECIAL PROCESS SERVER, AND NOTICE OF HEARING ESTATE NAME: ______________________________ ESTATE NO. _________________ This is to certify that I have this day served the persons named in the above petition, who were ordered to be served by First-Class Mail, with a copy of the foregoing petition and order, by placing a copy of same in an envelope addressed to each, and depositing same in the United States Mail, First-Class, with adequate postage thereon. ______________________ ___________________________________ DATE PROBATE CLERK/DEPUTY CLERK CERTIFICATE OF MAILING OF ORDER OF DISMISSAL ESTATE NAME: ______________________________ ESTATE NO. _________________ This is to certify that I have this day served the proposed medical consent ward with a copy of the petition and order for dismissal by placing a copy of same in an envelope addressed to the proposed ward and depositing same in the United States Mail, First-Class, with adequate postage thereon. I have also served a copy of the order for dismissal in the same manner upon the persons required in said order to be so served. ______________________ ___________________________________ DATE PROBATE CLERK/DEPUTY CLERK GPCSF 36 [11] Eff. July 2021 PROBATE COURT OF _______________________________ COUNTY STATE OF GEORGIA IN RE: ) ESTATE NUMBER: ) _____________________________________, ) PROPOSED MEDICAL CONSENT WARD ) ORDER FOR DISMISSAL The above and foregoing petition having been read and considered pursuant to O.C.G.A. § 29-4-18, and based on the petition (and prior to the preliminary hearing)(and following a preliminary hearing)(and following an evidentiary hearing), it appears that there is not probable cause to believe that the proposed medical consent ward is in need of a temporary medical consent guardian. Therefore, it is hereby: ORDERED that the petition is dismissed. IT IS FURTHER ORDERED that a copy of the petition, the affidavit, if any, and this order be served on the proposed medical consent ward by First-Class Mail, and a copy of this order be served in the same manner upon the petitioner or his/her/their attorney. SO ORDERED this ____________ day of _______________________, 20____. _____________________________________ Judge of the Probate Court GPCSF 36 [12] Eff. July 2021 PROBATE COURT OF _______________________________ COUNTY STATE OF GEORGIA IN RE: ) ESTATE NUMBER: ) _____________________________________, ) PROPOSED MEDICAL CONSENT WARD ) RETURN OF SHERIFF/SPECIAL AGENT I have this day served the proposed medical consent ward, ________________________, personally with a copy of the petition for appointment of a temporary medical consent guardian and order for appointment of counsel, appointment of special process server, and notice of hearing. This ____ day of ______________________, 20____. _______________________________________________ Deputy Sheriff ____________________ County, Georgia _______________________________________________ Special Agent _______________________________________________ Printed Name (If return is by special agent:) Sworn to and subscribed before me, this ______ day of _________________, 20___. _________________________________ Notary Public/Clerk, Probate Court My Commission Expires: GPCSF 36 [13] Eff. July 2021 PROBATE COURT OF _______________________________ COUNTY STATE OF GEORGIA IN RE: ) ESTATE NUMBER: ) _____________________________________, ) PROPOSED MEDICAL CONSENT WARD ) ORDER FOR EVIDENTIARY HEARING A preliminary hearing was held on the above-referenced petition on _________________, 20 ___, and after considering the pleadings and the evidence taken at the hearing, IT IS ORDERED that an evidentiary hearing shall be conducted (in the Probate Court of ______________________________________ County, courtroom _______________________, (address)_________________________________________________________, Georgia at the following location: ___________________________________________________________) at ____ o’clock ___.m., on _________________________ (which is not later than four days after the preliminary hearing). IT IS FURTHER ORDERED that the petitioner(s), and the temporary medical consent guardian(s) to be appointed if different from the petitioner(s), attend the hearing and give testimony under oath as the Court may direct. IT IS FURTHER ORDERED that a clerk/deputy clerk shall serve by First-Class Mail a copy of this order on all interested parties who were served notice of the preliminary hearing and the following person(s): . SO ORDERED this ____________ day of _______________________, 20____. _______________________________________________ Judge of the Probate Court GPCSF 36 [14] Eff. July 2021 CERTIFICATE OF MAILING OF NOTICE OF EVIDENTIARY HEARING ESTATE NAME: ______________________________ ESTATE NO. _________________ This is to certify that I have this day served the persons named in the above petition, who were ordered to be served by First-Class Mail, with a copy of the foregoing notice of evidentiary hearing, by placing a copy of same in an envelope addressed to each and depositing same in the United States Mail, First-Class, with adequate postage thereon. ______________________ ___________________________________ DATE PROBATE CLERK/DEPUTY CLERK GPCSF 36 [15] Eff. July 2021 PROBATE COURT OF _______________________________COUNTY STATE OF GEORGIA IN RE: ) ESTATE NUMBER: ) _____________________________________, ) PROPOSED MEDICAL CONSENT WARD ) FINAL ORDER A preliminary hearing was held on the above-referenced petition on ____________________ 20 ___ (and an evidentiary hearing was held on __________________, 20____). After considering the pleadings and the evidence taken at the hearing(s), the Court makes the following: FINDINGS OF FACT 1. All procedural requirements of O.C.G.A. § 29-4-18 have been met. 2. The above-named proposed medical consent ward is in need of a temporary medical consent guardian by reason of ___________________________________________________. Such need appears to be limited to the following number of days: ___________________. The temporary medical consent guardian shall have the limited authority to consent, on behalf of the proposed medical consent ward, to surgical or medical treatment or procedures not prohibited by law that the proposed medical consent ward would have wanted had he or she not been incapacitated and that is in the best interest of the proposed medical consent ward, if known by the medical consent guardian. If the preferences of the medical consent ward are not known to the medical consent guardian, the medical consent guardian shall act in the best interest of the proposed medical consent ward. 3. After reasonable inquiry, a person authorized or willing to consent for the proposed medical consent ward under the provisions of O.C.G.A. § 31-9-2 was absent. The petitioner moved the Court to appoint _______________________________________________________ as temporary medical consent guardian, asserting that he or she should serve because _____________________________________________________________________________. CONCLUSIONS OF LAW The Court finds that the above-named proposed medical consent ward, hereinafter referred to as “the ward,” is in need of a temporary medical consent guardian because the ward lacks sufficient understanding or capacity to make significant responsible decisions regarding his or her medical treatment or the ability to communicate such decisions by any means. The temporary medical consent guardian is appointed for the sole and limited purposes of consenting to surgical or medical treatment or procedures on behalf of the ward that are not GPCSF 36 [16] Eff. July 2021 prohibited by law and that the ward would have wanted had he or she not been incapacitated, if known to the medical consent guardian, or, if the ward’s preferences are not known, that are in the best interest of the ward. The temporary medical consent guardianship shall terminate on the earliest of: (1) the Court’s removal of the temporary medical consent guardian; (2) the effective date of the appointment of a permanent guardian under O.C.G.A. § 29- 4-2; (3) the duration of the current hospitalization of the ward or the duration of a substantially continuous stay in another health care facility; or (4) 60 days from the date of appointment of the temporary medical consent guardian. IT IS THEREFORE ORDERED that _________________________________________ be, and hereby is, appointed temporary medical consent guardian of the ward. Letters of temporary medical consent guardianship shall issue to the temporary medical consent guardian upon his or her taking the required oath. The appointed temporary medical consent guardian shall have no authority to act on behalf of the medical consent ward until letters of temporary medical consent guardianship have issued. IT IS FURTHER ORDERED that the temporary medical consent guardian has the sole and limited authority to consent to surgical or medical treatment or procedures on behalf of the ward that are not prohibited by law and that the ward would have wanted had he or she not been incapacitated, if known to the medical consent guardian, or, if the ward’s preferences are not known, that are in the best interest of the ward. IT IS FURTHER ORDERED that the temporary medical consent guardian: [Initial one] is authorized to withdraw life-sustaining procedures; or is not authorized to withdraw life-sustaining procedures, unless hereafter authorized by the Court. IT IS FURTHER ORDERED that a copy of this order shall be hand delivered or mailed by First-Class Mail to the ward, the medical consent ward’s attorney, the medical consent guardian, the petitioner(s), and his/her/their attorney(s), if any. IT IS FURTHER ORDERED that the ward’s legal counsel shall make reasonable efforts to explain to the ward this order and the ward’s rights under this order. SO ORDERED this _____ day of _____________________, 20 ___. _____________________________________ Judge of the Probate Court GPCSF 36 [17] Eff. July 2021 CERTIFICATE OF MAILING OF FINAL ORDER I have this date mailed (or handed) a copy of the final order appointing temporary medical consent guardian to the medical consent ward, his/her attorney (his/her representatives), the medical consent guardian, the petitioner(s), and petitioner’s attorney(s). ______________________ ___________________________________ DATE PROBATE CLERK/DEPUTY CLERK GPCSF 36 [18] Eff. July 2021 STATE OF GEORGIA COUNTY OF ESTATE NO. LETTERS OF TEMPORARY MEDICAL CONSENT GUARDIANSHIP From: Judge of the probate court of said county. TO: , Medical Consent Guardian RE: , Medical Consent Ward Date of Birth: _________________ This Court has found that the above-named medical consent ward is in need of a temporary medical consent guardian for the sole and limited purpose of the medical consent guardian consenting, on behalf of the medical consent ward, to surgical or medical treatment or procedures that are not prohibited by law. This Court has designated you as such guardian, and you have taken your oath. You have agreed that you are willing and able to become involved in the medical consent ward’s health care decisions and that you are willing to exercise reasonable care, diligence, and prudence. You have also agreed to consent in good faith to medical or surgical treatment or procedures which the proposed medical consent ward would have wanted had he or she not been incapacitated. Where the proposed medical consent ward’s preferences are not known, you have agreed to act in the proposed medical consent ward’s best interest. These letters expire and the temporary medical consent guardianship terminates on the earliest of: (1) the Court’s removal of the temporary medical consent guardian; (2) the effective date of the appointment of a permanent guardian under O.C.G.A. § 29-4-2; (3) the duration of the current hospitalization of the medical consent ward or the duration of a substantially continuous stay in another health care facility; or (4) 60 days from the date these letters are issued. The temporary medical consent guardian (is) (is not) authorized to withdraw life-sustaining procedures. Given under my hand and official seal, the _____ day of ___________________, 20 ___. ______________________________________ Judge of the Probate Court The following must be signed if the judge does not sign the original of this document. Issued by: (Seal) PROBATE CLERK /DEPUTY CLERK GPCSF 36 [19] Eff. July 2021 STATE OF GEORGIA COUNTY OF ESTATE NO. OATH OF TEMPORARY MEDICAL CONSENT GUARDIAN IN RE: Estate of MEDICAL CONSENT WARD I do solemnly swear (or affirm) that I will well and truly perform the duties required of me as temporary medical consent guardian of the above-named medical consent ward. By taking this oath, I specifically agreed that I am: (1) willing and able to become involved in the proposed medical consent ward’s health care decisions; and (2) willing to exercise reasonable care, diligence, and prudence and to consent in good faith to medical or surgical treatment or procedures which the proposed medical consent ward would have wanted had he or she not been incapacitated. Where the medical consent ward’s preferences are not known, I agree to act in the proposed medical consent ward’s best interest. I understand that I (am)(am not) authorized to withdraw life-sustaining procedures (as per order of the Court). ______________________________________________ TEMPORARY MEDICAL CONSENT GUARDIAN Sworn to and subscribed before me, this ________ day of __________________, 20___. ______________________________________________ Clerk of the Probate Court