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Provisional Letters Pursuant To 15-14.5-302 C.R.S. JDF 781 - Colorado
| Provisional Letters Pursuant To 15-14.5-302 C.R.S. Form. This is a Colorado form and can be used in Probate Statewide . |
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District Court Denver Probate Court _________________________________ County, Colorado Court Address: _________________________________________________ In the Interests of: COURT USE ONLY Case Number: ___________________ _____________________________________________ Ward/Protected Person Division______ Courtroom ________ PROVISIONAL LETTERS PURSUANT TO §15-14.5-302, C.R.S. _____________________________________________ (Name) was appointed or qualified by this Court with an order for provisional appointment on _____________________________ (date) as: Conservator. These are Letters of Conservatorship Guardian. These are Letters of Guardianship for an incapacitated person. These Provisional Letters are proof of the Guardian's/Conservator's authority to act and shall expire 60 days from issuance, unless extended by order of the Court with the following limitations. The Guardian shall have access to Ward's medical records and information to the same extent that the Ward is entitled. The Guardian shall be deemed to be Ward's personal representative for all purposes relating to Ward's protected health information, as provided in HIPAA, Section 45 CFR 164.502(g)(2). The Guardian does not have the authority to obtain hospital or institutional care and treatment for mental illness, developmental disability or alcoholism against the will of the Ward pursuant to §15-14316(4), C.R.S. Other limitations: ______________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Date: _____________________________ ___________________________________ Probate Registrar/(Deputy)Clerk of Court CERTIFICATION Certification Stamp or Certified to be a true copy of the original in my custody and to be in full force and effect as of: Date: __________________________________ ____________________________________ Probate Registrar/(Deputy)Clerk of Court JDF 781 9/08 PROVISIONAL LETTERS PURSUANT TO §15-14.5-302, C.R.S American LegalNet, Inc. www.FormsWorkflow.com
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