Guardianship Questionnaire
The Law Office of Whitney L. Thompson, PLLC Please fill in the requested information and obtain as much of the requested documents as possible, and then bring the documents with you to our next conference. The person for whom you seek this Guardianship will be referred to as "Ward."
Today's Date
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Month
-
Day
Year
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Proposed Ward's Name
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First Name
Last Name
Client's DOB
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Month
-
Day
Year
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Ward's Place of Birth?
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City, State
Ward's Age
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Please enter your current age.
Ward's Sex
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Female
Male
Does the Ward have a SSN?
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Yes
No
Ward's SSN
*
This information will be kept confidential. Do not use any dashes or other symbols
Ward's Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the Ward Married?
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Yes
No
Does the Ward have a Job?
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Yes
No
Ward's Employer's Name
*
Ward's Job Title
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Ward's Employer's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Medical Information About Ward
Name of Ward's Primary Physician
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First Name
Last Name
Ward's Doctor's Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Ward's last Medical Examination
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Month
-
Day
Year
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Date of Ward's last Psychological Examination
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Month
-
Day
Year
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Date of Ward's last Intellectual Examination
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Month
-
Day
Year
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What type of guardianship are you seeking?
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Guardianship of Person and Estate
Guardianship of Person Only
Guardianship of Estate Only
How long are you requesting the term of the guardianship last?
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Year(s), month(s), or day(s)
Describe the facts that require that a Guardian be appointed for the Ward
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Provide as much information as possible.
Describe the Nature and degree of incapacity of the Ward:
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Provide as much information as possible.
Specify the area of protection and assistance the Ward needs:
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Provide as much information as possible.
Describe what limitations and/or rights you want to be included in the Court's Order:
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Provide as much information as possible.
Is there a Guardianship of any kind in Texas or any other state?
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Yes
No
If Yes, describe the other Guardianship that is in place.
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Please provide as much information as possible.
Name of person and/or institution that has care and custody of the proposed ward:
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Address of the person/institution that has care and custody of the proposed ward
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Does the proposed ward have an administrator?
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Yes
No
Administrator's Name
First Name
Last Name
Administrator's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Does someone hold a Power of Attorney for the Ward?
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Yes
No
Name of the Person who holds a Power of Attorney
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First Name
Last Name
Address of the person who holds a Power of Attorney
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Description of the Power of Attorney:
*
Please list any information you have about the Power of Attorney in place.
Are you seeking Guardianship of the Estate for the Ward?
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Yes
No
Proposed Ward's Property
Approximate value and description of Ward's estate (including compensation, pension, insurance, or allowance the Ward is entitled to, bank accounts, real estate, personal property, vehicles, etc.):
Please list the Ward's Income (if none, please type in none).
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Please provide as much information as possible.
Please list the Ward's Real Property (Give address and/or location and general description of the property).
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Please provide as much information as possible.
Please list the Ward's Personal Property (Give general description such as, stocks and bonds, bank accounts, household goods, and jewelry. Please included the estimated values of each item).
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Please provide as much information as possible, and be sure to inlcude the estimated value of each item.
Ward's Relatives
Names and address of Ward's parents, siblings, and children (if necessary please bring in a separate sheet of paper with additional names and information).
(1) Relative's Name
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First Name
Last Name
(1) Relative's Relationship to Wad?
*
(1) Relative's Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(1) Do you have another relative to enter?
*
Yes
No
(2) Relative's Name
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First Name
Last Name
(2) Relative's Relationship to Wad?
*
(2) Relative's Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(2) Do you have another relative to enter?
*
Yes
No
(3) Relative's Name
*
First Name
Last Name
(3) Relative's Relationship to Wad?
*
(3) Relative's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(3) Do you have another relative to enter?
*
Yes
No
(4) Relative's Name
*
First Name
Last Name
(4) Relative's Relationship to Wad?
*
(4) Relative's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(4) Do you have another relative to enter?
*
Yes
No
(5) Relative's Name
*
First Name
Last Name
(5) Relative's Relationship to Wad?
*
(5) Relative's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(5) Do you have another relative to enter?
*
Yes
No
(6) Relative's Name
*
First Name
Last Name
(6) Relative's Relationship to Wad?
*
(6) Relative's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(6) Do you have another relative to enter?
*
Yes
No
(7) Relative's Name
*
First Name
Last Name
(7) Relative's Relationship to Wad?
*
(7) Relative's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(if necessary please bring in a separate sheet of paper with additional names and information).
Proposed Guardian
Please provide the proposed Guardian's information. This is the person who would be filing an application to be the Ward's Guardian.
Proposed Guardian's Name
*
First Name
Last Name
Proposed Guardian's Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Proposed Guardian's Email Address
*
Please include an email address that the proposed guardian would like to be contacted at about the case.
Is the Proposed Guardian a resident of Texas?
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Yes
No
If No, list the name and address of the registered agent who can accept service of process:
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Proposed Guardian's Number
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Area Code
Phone Number
Proposed Guardian's Relationship to Ward
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Proposed Guardian's Age
*
Proposed Guardian's Current Occupation:
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Has the Proposed Guardian every been adjudicated by a court to be incapacitated?
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Yes
No
Is the Proposed Guardian indebted to the Ward?
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Yes
No
Is the Proposed Guardian a party to a lawsuit against the Ward?
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Yes
No
Will anyone object to the Proposed Guardian
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Yes
No
If Yes, who?
*
Submit
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