Free Findings and Recommendations of Mental Hygiene Commissioner - West Virginia

IN THE CIRCUIT COURT OF _______________ COUNTY, WEST VIRGINIA
For Clerk's Use Only IN RE: ___________________________________________________________, DATE FILED: ____________________________________ A PROTECTED PERSON

CASE NUMBER ___________ - G - __________

FINDINGS AND RECOMMENDATION OF MENTAL HYGIENE COMMISSIONER ON PETITION TO TERMINATE, REVOKE OR MODIFY APPOINTMENT
[West Virginia Code: § 44A-4-6]

On this ______ day of _____________________________, 20______, came the Petitioner in the above styled cause for a hearing pursuant to the provisions of West Virginia Code: § 44A-4-7 and § 44A-2-9, it appearing to the undersigned, and the undersigned hereby finds, that due and proper notice of these proceedings has been given as required by West Virginia Code: § 44A2-6 and that this matter has matured for hearing on the Petition hereinbefore filed. The following parties to this action appeared at the hearing as follows [initial all appropriate appearances, as indicated, and record names of parties appearing, where applicable]: __________ The alleged Protected Person named above appeared in person and was, by the undersigned, verbally informed of the rights, of the contents of the petition, and of the purpose and legal effect of granting the relief requested in the petition as such matters are required by, West Virginia Code: § 44A-2-9(c). The alleged Protected Person DID NOT appear. [If this item is initialed, § 44A-4-7 requires a finding of good cause to excuse the presence of the Protected Person. If this is the case, insert such findings here.] _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ __________ __________ __________ Appointed counsel for the alleged Protected Person: __________________________________________________. The Petitioner: _________________________________________________________________________________. Counsel for the Petitioner: _______________________________________________________________________.

__________

SCA-CG 912-1 / 6-94

Findings and Recommendations of Mental Hygiene Commissioner on Petition to Terminate, Revoke or Modify Appointment Page 1 of 3 Pages

(APPEARANCES CONTINUED FROM PAGE 1)

__________

Parties who appeared: [List the names of all parties who appeared at the hearing. If an entity appeared by a representative, list the name of the entity and the name of the person representing that entity.] _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________

__________

Guardian and/or Conservator: _____________________________________________________________________

[West Virginia Code: § 44A-4-7 requires the guardian and/or conservator to attend the hearing, except for good cause shown. If no appearances are entered here, state the good cause shown to excuse such attendance.] _____________________________________________________________________________________________ _____________________________________________________________________________________________

__________

Other appearances: [List here any other appearances where permission to observe or participate was granted, upon application, under § 44A-2-9(b).] _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________

Upon consideration of the Evaluation Report of _______________________________________________, a licensed physician/psychologist, and upon consideration of the sworn testimony of the following witnesses [insert name(s) of witnesses testifying at the hearing]: ________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ the undersigned mental hygiene commissioner, based upon clear and convincing evidence, hereby makes the following findings and/or recommendations: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________

SCA-CG 912-2 / 6-94

Findings and Recommendations of Mental Hygiene Commissioner on Petition to Terminate, Revoke or Modify Appointment Page 2 of 3 Pages

__________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ These findings and recommendations are made this ______ day of __________________, 20 ________, with __________ pages [insert number of additional pages attached, if any] attached hereto and made a part hereof.

____________________________________ MENTAL HYGIENE COMMISSIONER

SCA-CG 912-3 / 6-94

Findings and Recommendations of Mental Hygiene Commissioner on Petition to Terminate, Revoke or Modify Appointment Page 3 of 3 Pages