ORDER APPOINTING
GUARDIAN AD LITEM / ATTORNEY /
LAWYER-GUARDIAN AD LITEM

JIS CODE:  GAL

FILE NO.

1. It appears to the court that

a lawyer-guardian ad litem
a guardian ad litem
should be appointed in this proceeding for the individual(s) named or described below.

an attorney

Approved,  SCAO

STATE OF MICHIGAN
PROBATE COURT
COUNTY OF

In the matter of

IT IS ORDERED:

2.

Name (type or print)

Address

City, state, zip

is appointed

guardian ad litem

lawyer-guardian ad litem

attorney

Telephone no.

for the following individual(s):

in respect to the following proceedings:

3. The guardian ad litem shall meet with the individual before the hearing and, to the extent that the person can comprehend,

explain the nature of the proceedings. In addition, if the matter involves a petition to appoint a guardian for a legally
incapacitated individual, the guardian ad litem shall give the individual form PC 626, Notice of Rights to Alleged Incapacitated
Individual, as required by MCL 700.5306a(2).

4. A written report with recommendations shall be filed with the court       at least 24 hours before the hearing.

Specify other time frame

                           .

5. The guardian ad litem shall be present at the time of hearing.

6. The guardian ad litem shall have access to all records, including but not limited to, medical records, psychological and psychiatric
records, any protective service reports/contacts, and other materials or documents which he or she shall request regarding this
matter. The guardian ad litem shall keep all information confidential, except upon further order of the court.

7. The lawyer-guardian ad litem must comply with the provisions of MCL 712A.17d or MCL 722.24.

Date

Judge

Bar no.

Do not write below this line - For court use only

PC 642  (9/12)   ORDER APPOINTING GUARDIAN AD LITEM / ATTORNEY / LAWYER-GUARDIAN AD LITEM

MCL 700.1403(d), MCL 700.5213(4), MCL 700.5219(4), MCL 700.5303(2),
MCL 700.5306a(2), MCL 700.5406(1), (2), MCR 5.121, MCR 5.404(B)(2)