pjc-family-2024-lib

G UARDIANSHIP OF A DULT

PJC 240.3

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? 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 “Yes” to any part of Question ______ [ 240.3B ], then answer the corresponding part of Question ______ [ 240.3C ]. Otherwise, do not answer Question ______ [ 240.3C ]. PJC 240.3C Lack of Capacity to Care for Self (Guardianship of the Person)—Partial—With Supports and Services QUESTION ______ Does PROPOSED WARD lack the capacity to perform the following tasks

even with the 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?

309