San Bernardino — 13-00500-360

Source: https://sanbernardino.courts.ca.gov/system/files/forms-filing/13-00500-360orderappointingguardianadlitemguardianshipestate.pdf

For Court Use OnlyATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NO.: NAME: FIRM NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NO.: FAX NO.: E-MAIL: ATTORNEY FOR: SUPERIOR COURT OF CALIFONIA, COUNTY OF SAN BERNARDINO STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: Guardianship of the Person and Estate of: CASE NUMBER: Estate of:

HEARING DATE AND TIME:

JUDICIAL OFFICER: DEPT:
ORDER APPOINTING GUARDIAN AD LITEM –
GUARDIANSHIP/ESTATE

This Court, on _________________ (date), at__________(time) at ___________(department)

hereby appoints ________________________________________________as Guardian Ad Litem

[hereinafter “GAL”] to protect the rights and best interests of:

______________________________________________________________[hereinafter “Minor”]

and to be of beneficial assistance to the Court in the resolution of the matter.

THE COURT ORDERS, the Guardian Ad Litem shall have:

Access to a complete case file from the court, without charge;

Authority to file with the court, without charge, any petition, motion or legal pleading that may be of benefit to Minor;

Access to obtain copies of court documents and to obtain certified copies of any court documents, without charge;

Right to notice of any proceeding to which Minor is entitled to notice;

Filed with the Court a written report by the next hearing date;

Reasonable access for visitation with Minor with adequate notice;

Access to any mental health and/or medical professional treating the Minor;

Right to obtain medical records for Minor. The right to obtain medical information which would otherwise be protected and is governed under the Health Insurance Portability and

Form Approved for Mandatory Use Order Appointing Guardian Ad Litem - Form # 13-00500-360 Guardianship/Estate Rev. 7/01/2026

Accountability Act of 1996 [HIPPA], 42 USC §1320d and 45 CFR pts 160, 164, and California law. This release of information extends to all health care providers with respect to rights regarding the use and disclosure of identifiable protected health information or other medical records. This release of information extends to all medical persons including, but not limited to, any physician, health care professional, dentist, health plan, hospital;

Right to Seek independent psychological or medical evaluation of Minor for purpose of any pending proceedings, upon application to the Court;

Right to Obtain copies of any and all estate planning documents which names Minor as the primary or contingent beneficiary, including but not limited to the following: Wills, Trusts, Powers of Attorney, Beneficiary Designations, and Transfer of Death Deeds;

Right to File for or obtain an injunction, temporary restraining order, restraining order, protective order or any other type of injunction or protective order to protect Minor;

Right to seek a special needs trust, trust or other testamentary instrument for the benefit of Minor, subject to Court approval;

Right to obtain any and all Educational Records and information of Minor, including, but not limited to, any assessments, assessment plans, testing, reports, Individualized Education Plans, Attendance Records, School Medical Records (including immunizations, testing and care plans), and Special Education Records;

Right to obtain preliminary settlement, subject to Probate Court approval of settlement agreements, including, but not limited to, minor’s compromises, special needs trusts, and blocked accounts. (Prob. Code §§ 3500, 3600 et seq.; Cal. Rules of Court 7.950–7.955);

Exclusive authority to advocate for a minor in litigation, including but not limited to, deciding strategy, filing pleadings, obtain discovery, trial decisions, object to proposed settlements that are not in the Minor’s best interest.

Other orders (specify):

Date:

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Signature of Judicial Officer

Form Approved for Mandatory Use Order Appointing Guardian Ad Litem - Form # 13-00500-360 Guardianship/Estate Rev. 7/01/2026