GC-385 Order Authorizing Conservator to Give Consent for Medical Treatment

Source: https://www.courts.ca.gov/documents/gc385.pdf

GC-385 ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER: FOR COURT USE ONLY NAME: FIRM NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NO.: FAX NO.: E-MAIL ADDRESS: ATTORNEY FOR (name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CONSERVATORSHIP OF THE PERSON ESTATE OF (Name):

CONSERVATEE
ORDER AUTHORIZING CONSERVATOR TO GIVE CASE NUMBER:
CONSENT FOR MEDICAL TREATMENT

1. The petition for authority to give consent for medical treatment came on for hearing as follows (check items c, d, and e to indicate personal presence; complete item f): a. Judge (name): b. Hearing date: Time: Dept.: Div.: Room: c. Petitioner (name): d. Attorney for petitioner (name): e. Attorney for conservatee (name, address, and telephone):

   f. Conservatee was present unable to attend able but unwilling to attend and does not wish to contest the petition out of state

THE COURT FINDS 2. a. All notices required by law have been given. b. There is no form of medical treatment for which the conservatee has the capacity to give informed consent. c. Conservatee is an adherent of a religion that relies on prayer alone for healing as described in Probate Code section 2355(b). d. Attorney (name): has been appointed by the court as legal counsel to represent the conservatee in this proceeding. The cost for representation is: $ e. Conservatee has a major neurocognitive disorder (such as dementia) as described in Probate Code section 2356.5, and the court finds all other facts required to make the orders specified in item 4. THE COURT ORDERS 3. a. Conservatee lacks the capacity to give informed consent to any medical treatment and the conservator of the person is granted the powers specified in Probate Code section 2355. b. Treatment is to be given by an accredited practitioner of the conservatee's religion under Probate Code section 2355(b). c. The order dated: made under Probate Code section 1880 is revoked modified as stated below as stated in Attachment 3c. d. For legal services rendered, conservatee conservatee's estate shall pay to (name): the sum of: $ forthwith as follows (specify terms): e. other (specify): f. Letters of Conservatorship shall reissue and include a statement that conservator has the powers ordered. g. This order shall terminate on (date): 4. a. The conservator of the person is granted authority to place conservatee in a secured-perimeter residential care facility as described in Probate Code section 2356.5(b). b. The conservator of the person is granted authority to authorize the administration of medications appropriate for the care and treatment of major neurocognitive disorders (including dementia) as described in Probate Code section 2356.5(c). 5. Total boxes checked in items 2–4: 6. Number of pages attached: Date: JUDICIAL OFFICER SIGNATURE FOLLOWS LAST ATTACHMENT

Form Adopted for Mandatory Judicial Council of California Use ORDER AUTHORIZING CONSERVATOR TO GIVE Probate Code,www.courts.ca.gov§ 1880 et seq. GC-385 [Rev. January 1, 2019] CONSENT FOR MEDICAL TREATMENT For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form Clear this form