pjc-family-2024-lib

G UARDIANSHIP OF A DULT

PJC 240.16

3. To make personal decisions regarding residence? Answer: _______________ 4. To make personal decisions regarding marriage? Answer: _______________ 5. To provide food, clothing, and shelter for himself ? Answer: _______________ 6. To consent to medical, dental, psychological, or psychiatric treat ment? Answer: _______________ If you answered “No” to any part of Question ______ [ 240.16B ], then answer the corresponding part of Question ______ [ 240.16C ]. Otherwise, do not answer Question ______ [ 240.16C ]. PJC 240.16C Restoration of Capacity—The Person—Partial—With Supports and Services QUESTION ______ Does WARD have the capacity to perform the following tasks with supports and services available to him ? Answer “Yes” or “No” for each of the following: [Repeat items as submitted in the prior question.] 1. To safely operate a motor vehicle? Answer: _______________ 2. To vote in a public election? Answer: _______________ 3. To make personal decisions regarding residence? Answer: _______________ 4. To make personal decisions regarding marriage?

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