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Report Of Guardian On Condition Of Individual With Developmental Disability PC 663 - Michigan
| Report Of Guardian On Condition Of Individual With Developmental Disability Form. This is a Michigan form and can be used in Guardianships and Conservatorships Probate Statewide . |
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Approved, SCAO OSM CODE: RGD STATE OF MICHIGAN FILE NO. REPORT OF GUARDIAN ON PROBATE COURT COUNTY CONDITION OF INDIVIDUAL WITH DEVELOPMENTAL DISABILITY CIRCUIT COURT - FAMILY DIVISION This report must be completed yearly by the guardian, or more often if directed by the court. In the matter of , an individual with a developmental disability1. I, , am the guardian of the above named individual, and I report: Name (type or print) 2. Present age of the individual: Individuals date of birth: 3. Current address and telephone number of the individual: 4. The individuals present living arrangement is: own home relatives home Relationship hospital or medical center guardians home community placement home other: 5. The individual has been in the present residence since . Descriptions and addresses of every residence where the individual has lived during this reporting period and the length of stay at each residence are as follows:6. I rate the individuals present living arrangements as excellent. average. below average. Explain if below average 7. I believe the individual is content with the living situation. unhappy with the living situation. I recommend a more suitable residence as follows: Describe 8. The individuals mental condition has remained about the same. improved. deteriorated. Describe the changes 9. The individuals physical health has remained about the same. improved. deteriorated. Describe the changes 10. The individuals social condition has remained about the same. improved. deteriorated. Describe the changes (PLEASE SEE OTHER SIDE) Do not write below this line - For court use only Date Signature of reviewer Court action to be taken MCL 330.1631, MCR 5.409(A)PC 663 (9/02) REPORT OF GUARDIAN ON CONDITION OF INDIVIDUAL WITH DEVELOPMENTAL DISABILITY <<<<<<<<<********>>>>>>>>>>>>> 211. The individual has received the following services: medical. educational. vocational. other professional services. Describe 12. My visits with and activities on behalf of the individual were: 13. I believe the individual has the following needs: 14. I have the following questions concerning the individual or my responsibilities: 15. Other information requested by the court or necessary in the opinion of the guardian is as follows: 16. The guardianship should should not be continued because: 17. As guardian, I have been ordered by the court to file an annual account which is attached. 18. Comments: Date Signature of guardian Address City, state, zip Telephone no. STATEMENT BY STANDBY GUARDIAN I am the appointed standby guardian and am willing to continue to serve in the event the guardian dies, becomes unable to serve,or resigns from the guardianship. Date Signature of standby guardian
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