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Here is the text we could read:

ATTORNEY OR PARTY WITHOUT ATTORNEY

STATE BAR NUMBER:

FOR COURT USE ONLY

GC-385

NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

TELEPHONE NO.:

E-MAIL ADDRESS:

ATTORNEY FOR (name):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

STATE:

FAX NO.:

ZIP CODE:

CONSERVATORSHIP OF THE

PERSON

ESTATE OF (Name):

ORDER AUTHORIZING CONSERVATOR TO GIVE
CONSENT FOR MEDICAL TREATMENT

CONSERVATEE

CASE NUMBER:

Judge (name):
Hearing date:

The petition for authority to give consent for medical treatment came on for hearing as follows (check items c, d, and e to indicate
personal presence; complete item f):
a.
b.
c.
d.
e.

Petitioner
Attorney for petitioner
Attorney for conservatee

(name, address, and telephone):

(name):

Room:

Dept.:

Time:

Div.:

unable to attend

able but unwilling to attend and does not wish to contest the

Conservatee was
petition

out of state

present

THE COURT FINDS
2.

All notices required by law have been given.

a.
b.
c.

b.
c.

e.
f.
g.

There is no form of medical treatment for which the conservatee has the capacity to give informed consent.
Conservatee is an adherent of a religion that relies on prayer alone for healing as described in Probate Code section
2355(b).
Attorney
represent the conservatee in this proceeding. The cost for representation is:
Conservatee has a major neurocognitive disorder (such as dementia) as described in Probate Code section 2356.5, and
the court finds all other facts required to make the orders specified in item 4.

has been appointed by the court as legal counsel to

(name):

THE COURT ORDERS
3.

Conservatee lacks the capacity to give informed consent to any medical treatment and the conservator of the person is
granted the powers specified in Probate Code section 2355.
Treatment is to be given by an accredited practitioner of the conservatee's religion under Probate Code section 2355(b).
The order
revoked

made under Probate Code section 1880 is

dated:

modified

as stated below

as stated in Attachment 3c.

conservatee

conservatee's estate shall pay to

the sum of: $

forthwith

Letters of Conservatorship shall reissue and include a statement that conservator has the powers ordered.

The conservator of the person is granted authority to place conservatee in a secured-perimeter residential care facility as
described in Probate Code section 2356.5(b).
The conservator of the person is granted authority to authorize the administration of medications appropriate for the care
and treatment of major neurocognitive disorders (including dementia) as described in Probate Code section 2356.5(c).

For legal services rendered,
(name):

as follows

(specify terms):

other (specify):

This order shall terminate on

(date):

Total boxes checked in items 2–4:

Number of pages attached:

6.
Date:

Form Adopted for Mandatory Use
Judicial Council of California
GC-385 [Rev. January 1, 2019]

ORDER AUTHORIZING CONSERVATOR TO GIVE
CONSENT FOR MEDICAL TREATMENT

JUDICIAL OFFICER

SIGNATURE FOLLOWS LAST ATTACHMENT

Page 1 of 1
Probate Code, § 1880 et seq.
www.courts.ca.gov

Order Authorizing Conservator to Give Consent for Medical Treatment

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 1
Fields(s): 69
Average fields per page: 69
Reading Level: Grade 9
LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

g_c_page__1 was GC-385[0].Page1[0].T127[0] (0.48 conf)
g_c_page__2 was GC-385[0].Page1[0].T127[1] (0.33 conf)
g_c_page_check_box__1 was GC-385[0].Page1[0].CheckBox1[0] (0.37 conf)
g_c_page_check_box__2 was GC-385[0].Page1[0].CheckBox1[1] (0.37 conf)
g_c_page_check_box__3 was GC-385[0].Page1[0].CheckBox1[2] (0.37 conf)
g_c_page_check_box__4 was GC-385[0].Page1[0].CheckBox1[3] (0.37 conf)
g_c_page_check_box__5 was GC-385[0].Page1[0].CheckBox1[4] (0.37 conf)
g_c_page_check_box__6 was GC-385[0].Page1[0].CheckBox1[5] (0.37 conf)
g_c_page_check_box__7 was GC-385[0].Page1[0].CheckBox1[6] (0.37 conf)
g_c_page_check_box__8 was GC-385[0].Page1[0].CheckBox1[7] (0.37 conf)
g_c_page_check_box__9 was GC-385[0].Page1[0].CheckBox1[8] (0.37 conf)
g_c_page_check_box__10 was GC-385[0].Page1[0].CheckBox1[9] (0.37 conf)
g_c_page_check_box__11 was GC-385[0].Page1[0].CheckBox1[10] (0.37 conf)
g_c_page_check_box__12 was GC-385[0].Page1[0].CheckBox1[11] (0.37 conf)
g_c_page__3 was GC-385[0].Page1[0].T127[2] (0.33 conf)
g_c_page_check_box__13 was GC-385[0].Page1[0].CheckBox1[12] (0.37 conf)
g_c_page_check_box__14 was GC-385[0].Page1[0].CheckBox1[13] (0.37 conf)
c_page_p_court_info_county was GC-385[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCounty[0] (0.36 conf)
c_page_p_caption_court_info was GC-385[0].Page1[0].P1Caption[0].CourtInfo[0].CrtBranch[0] (0.36 conf)
g_c_page_p_caption_court_info_crt_city_zip was GC-385[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCityZip[0] (0.35 conf)
c_page_p_caption_info_street was GC-385[0].Page1[0].P1Caption[0].CourtInfo[0].CrtStreet[0] (0.36 conf)
page_p_caption_court_info_mailing was GC-385[0].Page1[0].P1Caption[0].CourtInfo[0].CrtMailingAdd[0] (0.41 conf)
c_page_p_title_party_name was GC-385[0].Page1[0].P1Caption[0].TitlePartyName[0].Party1[0] (0.38 conf)
g_c_page_p_case_number was GC-385[0].Page1[0].P1Caption[0].CaseNumber[0].CaseNumber[0] (0.37 conf)
c_page_p_party_info_state was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].State[0] (0.39 conf)
g_c_page_p_party_info__1 was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Zip[0] (0.39 conf)
c_page_p_party_info_city was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].City[0] (0.39 conf)
c_page_p_party_info_street was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Street[0] (0.39 conf)
c_page_p_party_info_firm was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Firm[0] (0.39 conf)
c_page_p_party_info_name was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Name[0] (0.39 conf)
c_page_p_party_info_phone was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Phone[0] (0.39 conf)
c_page_p_caption_party_info was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Fax[0] (0.39 conf)
c_page_p_party_info_email was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Email[0] (0.39 conf)
g_c_page_p_party_info__2 was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].AttyFor[0] (0.40 conf)
c_page_p_party_info_bar was GC-385[0].Page1[0].P1Caption[0].AttyPartyInfo[0].BarNo[0] (0.38 conf)
g_c_page_fill_text was GC-385[0].Page1[0].FillText1140[0] (0.38 conf)
g_c_page_check_box__15 was GC-385[0].Page1[0].CheckBox1[14] (0.37 conf)
g_c_page_check_box__16 was GC-385[0].Page1[0].CheckBox1[15] (0.37 conf)
g_c_page__4 was GC-385[0].Page1[0].T128[0] (0.33 conf)
g_c_page__5 was GC-385[0].Page1[0].T127[3] (0.33 conf)
g_c_page__6 was GC-385[0].Page1[0].T240[0] (0.33 conf)
g_c_page__7 was GC-385[0].Page1[0].T123[1] (0.33 conf)
g_c_page__8 was GC-385[0].Page1[0].T123[2] (0.33 conf)
g_c_page__9 was GC-385[0].Page1[0].T123[3] (0.33 conf)
g_c_page__10 was GC-385[0].Page1[0].T123[4] (0.33 conf)
g_c_page__11 was GC-385[0].Page1[0].T127[4] (0.33 conf)
g_c_page__12 was GC-385[0].Page1[0].T153[1] (0.33 conf)
g_c_page_con_cb__1 was GC-385[0].Page1[0].con_cb[0] (0.32 conf)
g_c_page_con_cb__2 was GC-385[0].Page1[0].con_cb[1] (0.32 conf)
g_c_page_con_cb__3 was GC-385[0].Page1[0].con_cb[2] (0.32 conf)
g_c_page_con_cb__4 was GC-385[0].Page1[0].con_cb[3] (0.32 conf)
g_c_page__13 was GC-385[0].Page1[0].T128[1] (0.33 conf)
g_c_page_check_box__17 was GC-385[0].Page1[0].CheckBox1[16] (0.37 conf)
g_c_page_check_box__18 was GC-385[0].Page1[0].CheckBox1[17] (0.37 conf)
g_c_page_check_box__19 was GC-385[0].Page1[0].CheckBox1[18] (0.37 conf)
g_c_page_check_box__20 was GC-385[0].Page1[0].CheckBox1[19] (0.37 conf)
g_c_page_check_box__21 was GC-385[0].Page1[0].CheckBox1[20] (0.37 conf)
g_c_page_check_box__22 was GC-385[0].Page1[0].CheckBox1[21] (0.37 conf)
g_c_page_check_box__23 was GC-385[0].Page1[0].CheckBox1[22] (0.37 conf)
g_c_page_check_box__24 was GC-385[0].Page1[0].CheckBox1[23] (0.37 conf)
g_c_page_check_box__25 was GC-385[0].Page1[0].CheckBox1[24] (0.37 conf)
g_c_page__14 was GC-385[0].Page1[0].T127[5] (0.33 conf)
g_c_page__15 was GC-385[0].Page1[0].T240[1] (0.33 conf)
g_c_page__16 was GC-385[0].Page1[0].T127[6] (0.33 conf)
g_c_page_check_box__26 was GC-385[0].Page1[0].CheckBox1[25] (0.37 conf)
g_c_page__17 was GC-385[0].Page1[0].T127[7] (0.33 conf)
g_c_page__18 was GC-385[0].Page1[0].T128[2] (0.33 conf)
g_c_page__19 was GC-385[0].Page1[0].T153[2] (0.33 conf)
g_c_page__20 was GC-385[0].Page1[0].T153[3] (0.33 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Order Authorizing Conservator to Give Consent for Medical Treatment

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02