Approved, SCAO

STATE OF MICHIGAN

JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY

REQUEST AND ORDER FOR
COURT-APPOINTED ATTORNEY/
GUARDIAN AD LITEM
FOR WAIVER OF PARENTAL CONSENT

FILE NO.

In the matter of the petition of

, a minor, for waiver of parental consent for an abortion

Initials

REQUEST

1. The minor requests the appointment of

an attorney

a guardian ad litem

to assist her in proceedings

for a waiver of parental consent for an abortion.

Initials of minor/Signature of next friend

Bar no.

Name of attorney/guardian ad litem (type or print)

Bar no.

Date

3.

2. Date of hearing:

IT IS ORDERED:

Address

City, state, zip

consent for an abortion.

Date

Notice:

ORDER

Judge:

Telephone no.

Judge

is appointed

attorney

guardian ad litem

to represent the minor on her petition for waiver of parental

• The minor must contact the attorney or guardian ad litem within the next 24 hours.

• The attorney or guardian ad litem must consult with the minor within the next 48 hours and must ensure the confidentiality

of proceedings at all times.

• The hearing on the petition will be held within 72 hours after the petition is filed.

Do not write below this line - For court use only

PC 118  (9/10)   REQUEST AND ORDER FOR COURT-APPOINTED ATTORNEY / GUARDIAN AD LITEM FOR WAIVER OF

PARENTAL CONSENT

MCL 722.904(2), MCR 3.615



Request and Order for Court-Appointed Attorney/Guardian Ad Litem for Waiver of Parental Consent

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan 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 www.courts.michigan.gov/Abortion-Waiver (2023-03)
• Page(s): 1
• Fields(s): 8
• Average fields per page: 8
• Reading Level: Grade 7
• LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

---

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.

---

Create an Interactive Version of this Form:

The Weaver creates a draft guided interview from a template form, like the one provided here. To learn more, read "Weaving" your form into a draft interview.