PS–11  

Rev. 8/12 

Request to be Guardian  
of an Intellectually Disabled Adult Relative 

Case Number (the clerk fills this in):

In the Probate Court of (county):  

 

Your First and Last Name 
(parent or sibling asking to be guardian) 

 

 

  

County, Alabama 

 

Respondent’s First and Last Name  
(the intellectually disabled adult) 

Parents and brothers or sisters who care for an intellectually disabled relative in their home may use this form to ask 
the Court to be appointed guardian so they may continue to care for their relative. (Ala. Code §26-2A-102(e))  

(cid:99)  Your information (person who wants to be guardian):  

street address  

city 

state  

zip 

phone # 

Your relationship to the intellectually disabled adult (check one):   (cid:133) Mother   (cid:133) Father  (cid:133) Sister  (cid:133) Brother 

 

If more than one person wants to be guardian, list the other person’s information below:  

street address  

city 

state  

zip 

phone # 

Your relationship to the intellectually disabled adult (check one): (cid:133) Mother   (cid:133) Father  (cid:133) Sister  (cid:133) Brother 

Information about your intellectually disabled relative:  

  Age:  

  Age:  

  Age:  

 

 

(cid:100) 

(cid:101)  

Name:  

Address:  

Name:  

Address:  

Name:  

Address:  

street address  

city 

state  

zip 

phone # 

Information about the intellectual disability:  

You must provide a medical report that describes your relative’s intellectual disability and ability to care for himself 
(cid:133)  The medical report is attached to this form. 
or herself.  (Check one): 
 
(cid:133)  I/We will give the Court a medical report before or at the hearing. 
 
(cid:102)  Read and sign below: 

• 

• 

• 
• 

• 

I/We now care for the intellectually disabled relative listed above in my/our home, and ask the Court to appoint 
me/us the legal guardian(s) in this case. 
I/We have the time, energy, and desire to continue to care for that adult, including providing food, clothing, 
shelter, and health care. 
I/We are able to make decisions about care, treatment, and well-being that are in that adult’s best interest. 
I/We ask the Court for a hearing and to find that the Respondent needs a guardian because s/he lacks 
sufficient understanding or capacity to make or communicate responsible decisions.  
I/We declare that the information provided on this form is true. 

Person asking to be  
guardian signs here:   

Other person (if any) asking  
to be guardian signs here:      

Notary fills out below— 
Sworn to and subscribed before me, the undersigned authority,  
By (Print name of notary):  
On this date:  
   
Notary/clerk signs here 

  
  
   

  Date:  

  Date:  

(Notary’s seal here) 

Rev. 8/12 

© 2012 Alabama State Bar