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INSTRUCTIONS FOR FILING PETITIONS FOR JUDICIAL CONSENT TO ABORTIONS PURSUANT TO A.R.S. §36-2152(B) If you are a pregnant minor, are unmarried and live with a parent, A.R.S. §36-2152(B) requires written consent from one of your parents, your guardian, or your conservator for you to obtain an abortion. These instructions will tell you how to petition a superior court judge to authorize an abortion without parental consent and how the Arizona courts will hear and decide your Petition. The proceedings are confidential. No information about you or your Petition will be available to the public. There is no cost to you in seeking a judicial order. 1. Filing the Petition. You must complete the form of Petition attached to these instructions by printing or typing the information needed and file it with a clerk of the superior court (see list of addresses, attached). You may use a fictitious name such as "Jane Doe" or initials such as "J.D." on the Petition, and you do not need to sign the Petition with your real name. However, you must put your real name and how the clerk can reach you on the Data Sheet. This Data Sheet with your real name will be kept separate from your case file; your true name will be kept confidential as required by the statute. If you file the Petition in person, you must do so at the office of a clerk of the superior court (see list of addresses). After you file the Petition, the clerk will ask you to wait while the file is opened and a hearing date is scheduled. If you file the Petition by mail, you must include a copy of the Data Sheet with your contact information so the clerk will know how to reach you. You should call the clerk of the superior court if you do not receive a Notice of Hearing within 48 hours of mailing the Petition. 2. Right to an Attorney. Pursuant to the statute, you have a right to be represented by an attorney at no expense to you. If you want to have a court-appointed attorney, please check the appropriate line on the Petition form. If possible, the clerk will inform you while you are waiting for the file to be opened of the name, address, and phone number of your court-appointed attorney. That attorney will represent you at the hearing and on any further appeal, if required. 3. The Hearing. When you file your Petition, the clerk will notify the assigned judge to arrange for a hearing. You have a right to a hearing and a ruling on your Petition within 48 hours of filing the Petition, excluding weekends and holidays. Before you leave the counter, if possible the clerk will give you a Notice stating the time and date of the
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hearing. If you mail your Petition to the clerk, or if you file it in person and no judge is available the same day, the clerk will inform you as soon as possible using the means you designate on the Data Sheet of the date and time of your hearing. Failure to attend the hearing may result in the Petition being denied. At the hearing, the judge must determine whether you are mature and capable of giving informed consent to the abortion. If you do not claim to be mature, or if the judge finds you are not mature, the judge must determine whether an abortion without consent from one of your parents, a guardian, or a conservator is in your best interests. The judge may ask you questions, and you have the right to introduce evidence at the hearing, concerning both of these determinations. The judge may decide to appoint a guardian ad litem to recommend to the judge what is in your best interests. There is no expense to you if a guardian ad litem is appointed, and such appointment will not delay the hearing unless you agree to a postponement. 4. The Ruling. Within 48 hours of filing your Petition, excluding weekends and holidays, the judge will issue his or her decision. If the judge finds you are mature and can give informed consent to the abortion, or that an abortion without consent from one of your parents, a guardian, or a conservator is in your best interests, the judge will enter an Order authorizing the abortion. If the judge grants your Petition, the clerk specialist will prepare a certified copy of the Order for you to provide to your doctor. If the judge denies your Petition, the clerk will provide a copy of the Order to you, on the same day it is issued, using the means you designate on the Data Sheet. You will also receive information about your right to appeal. See ¶¶ 5-7, below. If you do not receive a ruling within 48 hours of the hearing, you should call or come to the clerk's office. If the judge does not enter a ruling within 48 hours of your filing the Petition, the Petition is considered granted and the clerk specialist will prepare a document entitled Certification of the Clerk for you to provide to your doctor. 5. Appeal Rights. If you are dissatisfied with the ruling, you have a right to an appeal. If you want to appeal, you should do so as soon as possible. A Notice of Appeal must be received by and filed in the superior court clerk's office no later than 15 days after the file-stamped date on the superior court Order or you will lose your right to appeal. If the 15th day falls on a weekend or a date the superior court is closed, the last day to appeal will be the next day the superior court clerk's office is open.

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Prepare the Notice of Appeal form as you did the Petition and file it with the superior court clerk. There is no charge for filing an appeal. If you did not ask to be represented by a court-appointed attorney for the superior court hearing and want to be so represented on appeal at no charge to you, check the appropriate line on the Notice of Appeal. If you deliver your Notice of Appeal in person, the clerk will call and inform the appellate court clerk that an appeal has been filed. The court of appeals will set a hearing on your appeal to be held within 48 hours of filing the appeal form, excluding weekends and holidays. If possible, the superior court clerk will inform you of the location, time and place of that hearing while you wait. If that is not possible, the court of appeals clerk will contact you with that information using the means designated on the Data Sheet. If you mail the Notice of Appeal to the superior court clerk, you must provide contact information so you can be advised of the date and time of the appellate hearing. The superior court clerk will send you or your attorney a copy of the recording or transcript of the superior court hearing so that you have it prior to any appellate hearing. There is no cost to you for preparing the transcript or for the recording. 6. The Appeal Hearing. The court of appeals will hold the appeal hearing and issue a ruling on your appeal within 48 hours of the filing of your Notice of Appeal, excluding weekends and holidays. You may attend the appeal hearing in person or by telephone. If you indicate on the Notice of Appeal that you will attend the hearing by phone, the court of appeals will call you at the phone number you provide on the date and time indicated on the Notice of Hearing on Appeal. The court of appeals' decision will be provided to you using the means designated on the Data Sheet. 7. Further appellate review. If you are dissatisfied with the court of appeals' decision, you may file a Petition for Review to the Arizona Supreme Court. If you want the supreme court to review the matter, you should file a Petition for Review as soon as possible, but no later than 30 days after the court of appeals' ruling is filed. All of the procedures for filing the Notice of Appeal also apply to the Petition for Review, except the Petition for Review should be filed with the clerk of the court of appeals. A ruling must be issued within 48 hours of the filing of your Petition for Review, excluding weekends and holidays.

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SUPERIOR COURTS IN THE STATE OF ARIZONA
Superior Court in Apache County Sue Hall, Clerk P.O. Box 365 St. Johns, AZ 85936 Phone: (928) 337-7550 Fax: (928) 337-2771 P.O. Drawer CK Bisbee, AZ 85603 Phone: (520) 432-8581 Fax: (520) 432-4850 County Courthouse 200 N. San Francisco Flagstaff, AZ 86001 Phone: (928) 779-6535 Fax: (928) 779-6655 1400 E. Ash Globe, AZ 85501 Phone: (928) 425-3231, Extension 8560 Fax: (928) 425-7802 County Courthouse 800 Main St. Safford, AZ 85546 Phone: (928) 428-3100 Fax: (928) 428-0061 County Courthouse P.O. Box 1027 Clifton, AZ 85533 Phone: (928) 865-4242 Fax: (928) 865-5358 1316 Kofa Ave Ste. 607 Parker, AZ 85344 Phone: (928) 669-6131 Fax: (928) 669-2186

Superior Court in Cochise County Denise I. Lundin, Clerk

Superior Court in Coconino County Debra Young, Clerk

Superior Court in Gila County Margaret Toot, Clerk

Superior Court in Graham County Darlee Maylen, Clerk

Superior Court in Greenlee County Cheryl Bowen, Clerk

Superior Court in La Paz County Sheri Newman, Clerk

Superior Court in Maricopa County Michael K. Jeanes, Clerk Juvenile Court Center (Durango)

3125 W. Durango Phoenix, AZ 85009 Phone: (602) 506-4041 Fax: (602) 506-4124

South East Facility 222 E Javelina Ave. Melody Tinsley, Administrator, Juvenile Mesa, AZ 85210 Division Phone: (602) 506-4494 Fax: (602) 506-2852

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Superior Court in Mohave County Virlynn Tinnell, Clerk

P.O. Box 7000 Kingman, AZ 86402-7000 Phone: (928) 753-0790 Fax: (928) 753-0713, #4037 County Courthouse P.O. Box 668 Holbrook, AZ 86025 Phone: (928) 524-4188 Fax: (928) 524-4261 110 W. Congress, First Floor Tucson, AZ 85701 Phone: (520) 740-3201 Fax: (520) 798-3531 P.O. Box 2730 Florence, AZ 85232-2730 Phone: (520) 868-6296 Fax: (520) 868-6252 Santa Cruz County Complex 2150 N. Congress Drive Nogales, AZ 85621 Phone: (520) 375-7700 Fax: (520) 761-7857 County Courthouse Prescott, AZ 86301 Phone: (928) 771-3312 Fax: (928) 771-3111 County Courthouse 168 S. 2nd Avenue, Suite B Yuma, AZ 85364 Phone: (928) 329-2164 Fax: (928) 329-2007

Superior Court in Navajo County Juanita Mann, Clerk

Superior Court in Pima County Patricia Noland, Clerk

Superior Court in Pinal County Kristi Youtsey-Ruiz, Clerk

Superior Court in Santa Cruz County Delfina E. Bauch, Clerk

Superior Court in Yavapai County Jeanne Hicks, Clerk

Superior Court in Yuma County Beverly Frame, Clerk

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SUPERIOR COURT OF ARIZONA _________________ COUNTY
IN THE MATTER OF: ) ) ___________________________, ) a minor ) ) [Use fictitious name if petitioner ) has so requested] ) ) ___________________________________ ) CASE NO. _____________________ PETITION TO AUTHORIZE PHYSICIAN TO PERFORM ABORTION

I hereby request that this Court enter an order authorizing a physician to perform an abortion without the consent of my parent(s) or guardian or conservator, pursuant to A.R.S. § 362152(B). 1. 2. 3. I am ________ years old and my date of birth is ________________. I am aware that the Court will appoint an attorney to represent me, at no charge to me, if I so choose. ____ I request that the Court appoint an attorney to represent me in this matter, free of charge; OR ____ I do not request a court-appointed attorney. I have personally chosen to represent myself, and not be represented by an attorney; OR ____ I am represented by an attorney, as follows: Name of attorney _____________________________________________ Address ____________________________________________________ Telephone number ____________________________________________ 03.03.03 1

4. 5. 6. 7.

I believe I am _____ weeks pregnant or my expected due date is _____________. I want to terminate my pregnancy by abortion. ____ I am mature and capable of giving informed consent to the proposed abortion; AND ____ It is in my best interests to have an abortion without the consent of my parent(s), guardian, or conservator.

For the reasons above stated, I respectfully request that this Court authorize a physician to perform an abortion at my request, without the consent of a parent, guardian, or conservator.

DATE: _______________________

__________________________________________ (Petitioner's signature, using true name OR fictitious name OR initials)

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DATA SHEET Judicial Consent to Abortions for Minors Pursuant to A.R.S. § 36-2152(B)

Petitioner's true name: __________________________________________________ Fictitious name to be used (if any): _________________________________________ Name of attorney (if any): ________________________________________________ Attorney's address: _____________________________________________________ Attorney's phone number: ________________________________________________ Please indicate which of the following methods you wish to have the court use to contact you regarding this proceeding. In making your decision as to how you want to be contacted, please keep in mind that the court must keep this matter strictly confidential. ____ The court may telephone me at the following number: _______________ ____ The court may contact me by mail at the following address: Street Address: _________________________________________ City, State, and Zip Code: _________________________________ ____ The court may contact me at the following e-mail address: ____________________ ____ The court may contact me at the following fax number: ______________________ ____ I only want to be contacted personally and I am responsible for appearing in person at the office of the clerk of the superior court.

___________________ Date
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_____________________________________ Signature of Petitioner (Please use true name)

SUPERIOR COURT OF ARIZONA _________________ COUNTY
IN THE MATTER OF: ) ) ___________________________, ) a minor ) [Use true name of petitioner] ) ) ___________________________________ )

CASE NO. _____________________ CERTIFICATION OF THE CLERK

The petitioner in this matter has filed a Petition to Authorize Physician to Perform Abortion, pursuant to A.R.S. ' 36-2152(B). According to A.R.S. ' 36-2152(E), if the Court has not held the hearing on the petition and issued a ruling within forty-eight hours after the petition was filed, excluding weekends and holidays, the petition is deemed to have been granted and the consent requirement is waived. The Clerk of this Court hereby certifies as follows: 1. The petition in this matter was filed on _________________, 200__, at _____ o=clock __.m. 2. The Court was required to hold a hearing and issue a ruling on or before ________________, 200__, at _______ o=clock __.m. 3. No ruling in this matter was issued within the time required by A.R.S. ' 36-2152(E). DATED: ____________

____________________________________ Clerk of the Superior Court

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SUPERIOR COURT OF ARIZONA _________________ COUNTY
IN THE MATTER OF: ) ) ___________________________, ) a minor ) [Use fictitious name if petitioner ) has so requested] ) ___________________________________ ) 1. 2. 3. 4.

CASE NO. _____________________ NOTICE OF HEARING

Your hearing date is: __________________________. The location of your hearing is: ____________________________________. The time of your hearing is: _______________________________________. Your hearing judge is: ___________________________________________.

You are advised that failure to appear at the hearing at the time and date above may result in the denial of your petition. DATE: ________________ Mailed/hand-delivered to petitioner/petitioner's attorney on _______________, 200__. _____________________________ ___________________________________ Deputy Clerk

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SUPERIOR COURT OF ARIZONA _________________ COUNTY
IN THE MATTER OF: ) ) ___________________________, ) a minor ) ) [Use fictitious name if petitioner ) has so requested] ) ) ___________________________________ ) 1. 2. 3. 4. 5.

CASE NO. _____________________ NOTICE OF HEARING AND APPOINTMENT OF COUNSEL

Your hearing date is: __________________________. The location of your hearing is: ____________________________________. The time of your hearing is: _______________________________________. Your hearing judge is: ___________________________________________. Your appointed attorney is: Name: Address: Phone number: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________

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You are advised that failure to appear at the hearing at the time and date above may result in the denial of your petition.

DATE: ________________

___________________________________ Deputy Clerk

Mailed/hand-delivered to petitioner/petitioner's attorney on _______________, 200__. _____________________________

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SUPERIOR COURT OF ARIZONA _________________ COUNTY
IN THE MATTER OF: ) ) ___________________________, ) a minor ) [Use fictitious name if petitioner ) has so requested] ) ___________________________________ )

CASE NO. _____________________ ORDER DENYING PETITION

A hearing was held on a Petition to Authorize Physician to Perform Abortion on this ___ day of ___________, 200__. The petitioner was present. The record was kept by __________________. The name of the court reporter, if applicable, is __________________________________. The petitioner was sworn and testified. Based on the evidence presented, THE COURT FINDS AS FOLLOWS: 1. ____ The petitioner was represented by an attorney, _______________________, who was present at the hearing; OR ____ The petitioner was advised of her right to court-appointed counsel and has knowingly and intelligently waived her right to counsel. 2. ________________________ was appointed by the court to act as a guardian ad litem for petitioner. 3. The health or life of the petitioner is not threatened by the pregnancy or carrying the fetus to term. 4. The petitioner is not mature, is incapable of giving informed consent to the proposed abortion, and it is not in the petitioner's best interests to have the proposed abortion without consent from one of her parents or her guardian or conservator for the following reasons: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 03.03.03 1

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. THE COURT THEREFORE CONCLUDES AND ORDERS: 1. 2. The requirements of A.R.S. § 36-2152(B) have not been met. The petition is denied.

3. The clerk of the court shall forthwith provide petitioner or her attorney with a copy of this order and, if an appeal is filed, the record in this matter at no cost. 4. No member of the public shall inspect or obtain access to copies of this order or any other documents or records relating to this matter without the consent of the petitioner. 5. 6. The record and evidence in this matter shall remain sealed and confidential. No minute entry shall issue.

The Court has advised the petitioner and her attorney of the right to appeal. DATE: _______________ ____________________________________ Judge of the Superior Court

A copy hereof was hand-delivered/mailed to petitioner/petitioner's attorney, this __ day of _______, 200__. ______________________________ 03.03.03 2

SUPERIOR COURT OF ARIZONA _________________ COUNTY
IN THE MATTER OF: ) ) ___________________________, ) a minor ) [Use true name of petitioner] ) ) ___________________________________ )

CASE NO. _____________________ ORDER GRANTING PETITION

A hearing was held on a Petition to Authorize Physician to Perform Abortion on this ___ day of ____________, 200__. The petitioner was present. The record was kept by _________________. The name of the court reporter, if applicable, is _______________________________. The petitioner was sworn and testified. Based on the evidence presented, THE COURT FINDS AS FOLLOWS: 1. ____ The petitioner was represented by an attorney, _______________________, who was present at the hearing; OR ____ The petitioner was advised of her right to court-appointed counsel and has knowingly and intelligently waived her right to counsel. 2. _____________________________ was appointed by the court to act as a guardian ad litem for petitioner. 3. ____ The petitioner is mature and capable of giving informed consent to the proposed abortion; OR ____ The petitioner is not mature, but it is in the petitioner's best interests to have the proposed abortion without having to obtain consent from one of her parents or her guardian or conservator, based on the following factors: ______________________________________________________________________________ ______________________________________________________________________________ 03.03.03 1

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. THE COURT CONCLUDES AND ORDERS: 1. The requirements of A.R.S. § 36-2152(B) have been met.

2. The petition is granted. A physician chosen by the petitioner is hereby authorized to perform an abortion for petitioner without having to obtain the consent of her parents, guardian, or conservator. 3. The clerk of the court shall provide petitioner or her attorney with a certified copy of this order forthwith at no cost. 4. No member of the public shall inspect or obtain access to copies of this order or any other documents or records relating to this matter without the consent of the petitioner. 5. 6. The record and evidence in this matter shall remain sealed and confidential. No minute entry shall be issued.

DATE:___________ ___________________________________ Judge of the Superior Court A copy hereof was hand-delivered/mailed to petitioner/petitioner's attorney, this ___ day of _______, 200__. ____________________________ 03.03.03 2