Notice Of Confidential Information Within Court Filing {Form F}

Page 1 of 2 of Form F IN THE CIRCUIT COURT, EIGHTEENTH JUDICIAL CIRCUIT IN AND FOR BREVARD COUNTY, FLORIDA CASE NO.: IN RE: THE GUARDIAN ADVOCACY OF Name of Person with a Developmental Disability NOTICE OF CONFIDENTIAL INFORMATION WITHIN COURT FILING (Form F ) Pursuant to Florida Rule of Judicial Administration 2.420(d)(2), the filer of a court record at the time of filing shall indicate whether any confidential information is included within the document being filed; identify the confidentiality provision that applies to the identified information; and identify the precise location of the confidential information within the document being filed. Title/Type of Documents(s): Guardianship Reports Indicate the applicable confidentiality provision(s) below from Rule 2.420(1)(B), by specifying the location within the document on the space provided: Chapter 39 records relating to dependency matter, termination of parental righ ts, guardians as litem, child abuse, neglect and abandonment. 247 39.0132(3), Fl a. Stat. (If the document is filed within a Chapter 39 case, this form is not required.) Adoption records, 24763.162, Fla. Stat. (If the document is filed within a Chap ter 63 adoption case, this form is not required.) Social Security, bank account, charge, debit, and credit card numbers in court records. 247119.0714(1)(i) - (j), (2)(a) - (e), Fla. Stat. (Unless redaction is requested pursuant to 247119.0714(2), Fla. Stat. this information is exempt only as of January 1, 201 2 ). HIV test result and patient identity within the HIV results. 247381.004( 2 )(e), Fla. Stat. Sexually Transmitted diseases test results and identity within the test results wh en provided by the Birth and death certificates , including , court - issued delayed birth certificates and fetal death certificates. 247382.008(6) and 247 382.025(1)(a), Fla. Stat. Identifying information in petition , by minor , for waiver of parental notice when seeking to terminate pregnancy. 247390.01116, Fla. Stat. (If the document is filed within a Ch. 390 waiver of parental notice case, this f orm is not required.) Identifying information in clinical mental health records under the Baker Act. 247394.4615(7), Fla. Stat. American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 of Form F Records of substance abuse service providers which pertain to the identity, diagnosis, and prognosis of and service provision to individuals who have received services from substance abuse service providers. 247397.501(7), Fla. Stat. Identifying information in clinical records of detained criminal defendants found incompetent to proceed or acquitted by reason of insanity. 247916.107(8), Fla. Stat. Estate inventories and accountings. 247733.604(1), Fla. Stat. Information identifying victims of sexual offenses, including child sexual abuse. 247119.071(2)(h) and 247 119.0714(1)(h), Fla. Stat. Gestational surrogacy recor ds. 247742.16(9), Fla. Stat. X Guardianship reports and orders appointing court mo nitors in guardianship cases. 247744.1076 and 247 744.3701, Fla. Stat. Grand jury records. Ch 905, Fla. Stat. (If the document is filed in a Ch. 905 grand jur y proceeding , this form is not required.) Information acquired by courts and law enforcement regarding family services for children. 247984.06(3) - (4), Fla. Stat. (If the document is filed in a Ch. 984 family services for children case, this form is not required.) Juvenile delinquency records. 247985.04(1) and 247 985.045(2), Fla. Stat. (If the document is filed in a Ch. 985 juvenile delinquency case, this form is not required.) Information disclosing the identity of persons subj ect to tuberculosis proceedings and records of the Department of Health in suspected tuberculosis cases. 247392.545 and 247 392.65, Fla. Stat. Complete presentence investigation reports. Fla. R. Crim. P. 3.712. Forensic behavioral health e valuations under Chapter 916. 247 916.1065, Fla. Stat. Eligibility screening, substance abuse screening, behavioral health evaluations, and treatment status reports for defendants referred to or considered for referral to a drug court program. 247 39 7.334(10)(a), Fla. Stat. Signature of Petitioner Printed Name of Petitioner Note: The clerk of court shall review filings identified as containing information to determine whether the information is facially subject to confidentiality under the identified provision. The clerk shall notify the filer in writing within 5 days if the clerk determines that the information is NOT subject to confidentiality, and the records shall not be held as confidential for more than 10 days, unless a motion is filed pursuant to subdivision (d)(3) of Rule 2.420. American LegalNet, Inc. www.FormsWorkFlow.com