Statement Of Expert Evaluation {17.1}

FORM 17.1 - STATEMENT OF EXPERT EVALUATION [Sup.R. 66 & R.C. 2111.49]. This form is used in guardianship proceedings in the Ohio Probate Court by a qualified professional—such as a licensed physician, psychologist, social worker, professional clinical counselor, developmental disability team member, nurse practitioner, or clinical nurse specialist—to provide an expert assessment of the individual who is the subject of a guardianship case. The form documents the evaluator’s personal observations and medical findings regarding the person’s mental, physical, and functional abilities, including impairments, diagnosis (mental illness, intellectual disability, substance abuse, or dementia), and capacity to manage daily living, healthcare, and financial affairs. It also includes recommendations on the appropriate living situation, prognosis, and whether a guardianship should be established, denied, continued, or terminated. If used for emergency guardianship, an additional supplement (Form 17.1A) must explain the emergency circumstances and risk of injury or death. The form also includes an optional Guardian’s Report Addendum for updates confirming that the ward’s mental capacity will not improve. www.FormsWorkflow.com