______________________________ Name ______________________________ Address ____________________________________________________________ City ______________________________ Telephone _____________________________________________________________________________ IN THE _______________DISTRICT JUVENILE COURT FOR_________________COUNTY ______________________________________________________________________________ IN THE INTEREST OF_________________, ) FINDINGS OF FACT, CONCLUSIONS A MINOR. ) OF LAW AND ORDER ) JUVENILE NO._____________________ ) ) ______________________________________________________________________________ This matter came before the court on _______________, 20_____, for a hearing held pursuant to Utah Code Ann. § 76-7-304.5 on waiver of parental consent to a minor's abortion. Present for the hearing were the following: ______________________, the minor; ______________________, the minor's attorney; ______________________, the minor's guardian ad litem; and ______________________,_________________________. The proceeding was recorded]. The following exhibits and testimony were received into evidence:______________________________________________________.
The court now makes the following findings of fact: 1. Notice of this hearing was given to the Petitioner, her attorney, and the
individuals designated by the Petitioner. 2. The Petitioner is a pregnant minor, ______years of age. She is approximately
______weeks pregnant and seeks an abortion but has failed to obtain or chooses not to seek the consent of a parent or guardian. 3. (Initial One) The Petitioner is mature and capable of giving informed consent for the
abortion. This decision is based upon the following facts: ______________________________________________________________________________ ______________________________________________________________________________ OR _____b. The Petitioner is not mature (or does not claim to be mature), but an
abortion is in the Petitioner's best interest. This decision is based upon the following facts: ______________________________________________________________________________ ______________________________________________________________________________ OR
The Petitioner has not shown that she is mature and capable of providing
informed consent, nor has she shown that an abortion is in her best interest. This decision is based on the following facts: ______________________________________________________________________________ ______________________________________________________________________________ CONCLUSIONS OF LAW 1. The court has jurisdiction of the Petitioner and the subject matter as provided in
Utah Code Ann. § 76-7-304.5. 2. 3. The burden of proof is on the Petitioner by a preponderance of the evidence. (Initial One) A preponderance of the evidence shows that the Petitioner is mature and
capable of giving informed consent for the performance of the abortion. OR _____b. A preponderance of the evidence shows that the Petitioner is not mature or
does not claim to be mature, but an abortion is in the best interest of the Petitioner. OR _____c. parental consent. The evidence does not support that the abortion may proceed without
IT IS ORDERED, ADJUDGED AND DECREED that the Petition for Waiver of Parental
Consent is [granted/denied]. The clerk shall provide a copy of this order to the Petitioner's attorney, guardian ad litem, physician, and the following person(s) designated by the petitioner: ________________________ ______________________________________________________________________________ Notice: (Delete if petition is granted). You have the right to appeal this ruling to the Utah Court of Appeals. You must file a notice of appeal with the juvenile court clerk within thirty days of this ruling. The rules you must follow for the appeal are attached to this order. DATED this_________day of____________,20_____.
____________________________ JUVENILE COURT JUDGE