Free ¨ District Court ¨ Denver Probate Court - Colorado

District Court Denver Probate Court _________________________________County, Colorado Court Address: ______________________________________ In the Interests of: ______________________________________ COURT USE ONLY Case Number: ___________________ Division_______ Courtroom _________

Minor

ORDER APPOINTING EMERGENCY GUARDIAN FOR MINOR PURSUANT TO 15-14-204(5), C.R.S.
Upon consideration of the Petition for Appointment of Emergency Guardian for the above minor and hearing on ________________________ (date),

The Court finds that:
1. Venue is proper. 2. Notice pursuant to §15-14-204(5), C.R.S. was: Reasonable. Dispensed with because the Court finds from affidavit or testimony that the Minor will be substantially harmed before a hearing can be held on the Petition. 3. The person is a minor born on _________________________ (date). 4. Following the procedures in §15-14-201 et seq., is likely to result in substantial harm to the Minor's health or safety and no other person appears to have authority to act in the circumstances pursuant to §15-14-204(5), C.R.S. 5. The Minor's best interest will be served by the appointment of an Emergency Guardian. 6. The emergency guardianship can not exceed 60 days.

The Court appoints the following person as Emergency Guardian of the Minor:
Name: ___________________________________________________________________________________ Address: _________________________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ Email Address: __________________________ Home Phone #: ______________________________ Work Phone #: _________________________________

The Court directs the issuance of Letters of Guardianship as follows:
This emergency guardianship expires on _____________________ (date not to exceed 60 days from appointment.) The powers and duties of the Emergency Guardian are as follows: To perform any and all acts necessary for the day-to-day care, custody, education, recreation, and property of the Minor. To authorize any and all medical and dental care for the health and well being of the Minor. This care includes, but is not limited to medical and dental exams and tests, x-rays, surgeries, anesthesia, and hospital care. To authorize mental health treatment, subject to §27-10-107, C.R.S. Other: _________________________________________________________________________

JDF 829

6/08 ORDER APPOINTING EMERGENCY GUARDIAN FOR MINOR

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If the Emergency Guardian is appointed without notice, notice of the appointment must be given within 48 hours after the appointment and a hearing on the appropriateness of the appointment held within five days after the appointment. The hearing will be held at the following time and location: Date: ________________________ Time: __________ Courtroom or Division: ____________ Address: ______________________________________________________________________

The Court further orders: ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________

Date: __________________________

______________________________________ Judge Magistrate

JDF 829

6/08 ORDER APPOINTING EMERGENCY GUARDIAN FOR MINOR

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