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

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Here is the text we could read:

This is a private record. 

[  ] Petitioner 
[  ] Respondent 
[  ] Interested person 
[  ] Attorney for the [  ] Petitioner   [  ] Respondent    [  ] Interested person and my Utah Bar 
number is _________ 

In the District Court of Utah 

__________ Judicial District ________________ County 

Court Address ______________________________________________________ 

In the Matter of Protection for 

Request to Assign a Court Visitor 

___________________________________, 
Respondent/Protected Person 

_______________________________ 
Case Number 

_______________________________ 
Judge 

(1) 

I request that the court assign as a court visitor (Choose one.) 

[  ]  ________________________________________________________ (name), 

a person who is trained in law, nursing, or social work with no personal 
interest in the proceedings. 

[  ]  a volunteer from the court’s volunteer court visitor program.  

(2) 

I request that the visitor inquire about: (Choose one.) 

[  ]  whether to excuse the Respondent from attending the hearing under Section 

75-5-303(5)(a). 

[  ]  the Respondent/Protected Person’s circumstances and well-being. 

[  ]  the Respondent/Protected Person’s well-being and proposed guardian's 

future plans for the Respondent's residence under Section 75-5-303(5)(d). 

Request to Assign a Court Visitor 

Approved Board of District Court Judges June 15, 2012 
Revised May 8, 2018 

Page 1 of 3 

 

ity, State, Zip 

hone 

mail 

I am the 

  A

  C

  P

  E

 
Name 

ddress 

(3) 

I request that the visitor: (Choose all that apply.) 

[  ]  interview the Respondent/Protected Person; 

[  ]  interview the Proposed Guardian/Guardian; 

[  ]  interview the physician who has examined the Respondent/ Protected 

[  ]  visit the Respondent’s/Protected Person’s residence and/or proposed 

[  ]  conduct other inquiries and observations; (describe) 

and file a written report with the court. 

Person; 

residence; 

       

 declare under criminal penalty under the law of Utah that everything stated in this document is true. 

Signed at ______________________________________________________ (city, and state or country). 

 
Date 

Signature ► 

Printed Name 

 

 

Request to Assign a Court Visitor 

Approved Board of District Court Judges June 15, 2012 
Revised May 8, 2018 

Page 2 of 3 

    I

 

 

 

 

 

 

 
Date 

 

I certify that I filed with the court and served a copy of this Request to Assign a Court Visitor on the 
following people. 

Certificate of Service 

Person’s Name 

Method of Service 

Served at this 
Address 

Served on 
this Date 

 

 

 

[  ]  Mail 
[  ]  Hand Delivery 
[  ]  E-filed 
[  ]  Email (Person agreed to service by email.) 
[  ]  Left at business (With person in charge 

or in receptacle for deliveries.) 

[  ]  Left at home (With person of suitable 

age and discretion residing there.) 

[  ]  Mail 
[  ]  Hand Delivery 
[  ]  E-filed 
[  ]  Email (Person agreed to service by email.) 
[  ]  Left at business (With person in charge 

or in receptacle for deliveries.) 

[  ]  Left at home (With person of suitable 

age and discretion residing there.) 

[  ]  Mail 
[  ]  Hand Delivery 
[  ]  E-filed 
[  ]  Email (Person agreed to service by email.) 
[  ]  Left at business (With person in charge 

or in receptacle for deliveries.) 

[  ]  Left at home (With person of suitable 

age and discretion residing there.) 

 

 

 

Signature ► 

Printed Name 

 

 

Request to Assign a Court Visitor 

Approved Board of District Court Judges June 15, 2012 
Revised May 8, 2018 

Page 3 of 3

Request to Assign a Court Visitor

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Utah 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 legacy.utcourts.gov (2023-03)
Page(s): 3
Fields(s): 95
Average fields per page: 31
Reading Level: Grade 11
LIST Grouping(s): Unknown

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.

Here are the fields we could identify.

users1_name__1 was name (1.00 conf)
users1_address_line_one was address (1.00 conf)
city_state_zip was city__state__zip (0.35 conf)
users1_phone_number was phone (1.00 conf)
email was email (0.38 conf)
interested_person was interested_person (0.45 conf)
district_court_utah was in_the_district_court_of_utah (0.34 conf)
judicial_district was judicial_district (0.38 conf)
page_field__1 was page_0_field_8 (0.31 conf)
court_address was court_address (0.42 conf)
county was county (0.39 conf)
page_field__2 was page_0_field_11 (0.31 conf)
page_field__3 was page_0_field_12 (0.31 conf)
request_assign_court_visitor was request_to_assign_a_court_visitor (0.44 conf)
page_field__4 was page_0_field_14 (0.31 conf)
page_field__5 was page_0_field_15 (0.31 conf)
page_field__6 was page_0_field_16 (0.31 conf)
page_field__7 was page_0_field_17 (0.31 conf)
page_field__8 was page_0_field_18 (0.31 conf)
page_field__9 was page_0_field_19 (0.31 conf)
page_field__10 was page_0_field_20 (0.31 conf)
docket_number was case_number (1.00 conf)
page_field__11 was page_0_field_22 (0.31 conf)
page_field__12 was page_0_field_23 (0.31 conf)
matter_protection was in_the_matter_of_protection_for (0.37 conf)
respondent_protected_person__1 was respondent_protected_person (0.50 conf)
page_field__13 was page_0_field_26 (0.31 conf)
page_field__14 was page_0_field_27 (0.31 conf)
page_field__15 was page_0_field_28 (0.31 conf)
page_field__16 was page_0_field_29 (0.31 conf)
page_field__17 was page_0_field_30 (0.31 conf)
request_court_choose_one was i_request_that_the_court_assign_as_a_court_visitor__choose_one (0.47 conf)
judge was judge (0.39 conf)
page_field__18 was page_0_field_33 (0.31 conf)
person_law_social_personal was a_person_who_is_trained_in_law__nursing__or_social_work_with_no_personal (0.44 conf)
page_field__19 was page_0_field_35 (0.31 conf)
page_field__20 was page_0_field_36 (0.31 conf)
page_field__21 was page_0_field_37 (0.37 conf)
page_field__22 was page_0_field_38 (0.37 conf)
interest_proceedings was interest_in_the_proceedings (0.41 conf)
page_field__23 was page_0_field_40 (0.31 conf)
page_field__24 was page_0_field_41 (0.37 conf)
page_field__25 was page_0_field_42 (0.37 conf)
page__1 was page_1_of_3 (0.42 conf)
petitioners1_name was petitioner (1.00 conf)
respondents1_name was respondent (1.00 conf)
page_check__1 was page_0_check_2 (0.33 conf)
petitioner_respondent_interested_person was attorney_for_the_petitioner_respondent_interested_person_and_my_utah_bar (0.47 conf)
page_check__2 was page_0_check_4 (0.33 conf)
page_check__3 was page_0_check_5 (0.33 conf)
page_check__4 was page_0_check_6 (0.33 conf)
af_f was AFF051 (0.51 conf)
volunteer_court_program was a_volunteer_from_the_court_s_volunteer_court_visitor_program (0.39 conf)
whether_respondent_hearing was whether_to_excuse_the_respondent_from_attending_the_hearing_under_section (0.39 conf)
protected_person_circumstances was the_respondent_protected_person_s_circumstances_and_well_being (0.43 conf)
protected_person_well was the_respondent_protected_person_s_well_being_and_proposed_guardian_s (0.37 conf)
file_written_report_court was and_file_a_written_report_with_the_court (0.35 conf)
city_state_country was city__and_state_or_country (0.47 conf)
users1_signature was signature (1.00 conf)
page_field__26 was page_1_field_3 (0.36 conf)
page_field__27 was page_1_field_4 (0.36 conf)
page_field__28 was page_1_field_5 (0.36 conf)
declare_criminal_stated was i_declare_under_criminal_penalty_under_the_law_of_utah_that_everything_stated_in_this_document_is_true (0.52 conf)
signed was signed_at (0.36 conf)
page_field__29 was page_1_field_8 (0.36 conf)
signature_date was date (1.00 conf)
users1_name__2 was printed_name (1.00 conf)
page__2 was page_2_of_3 (0.42 conf)
respondent_protected_person__2 was interview_the_respondent_protected_person (0.49 conf)
interview_proposed_guardian was interview_the_proposed_guardian_guardian (0.47 conf)
examined_respondent_protected was interview_the_physician_who_has_examined_the_respondent__protected (0.38 conf)
protected_person_residence was visit_the_respondent_s_protected_person_s_residence_and_or_proposed (0.37 conf)
conduct_inquiries_describe was conduct_other_inquiries_and_observations_describe (0.35 conf)
page_field__30 was page_2_field_0 (0.31 conf)
page_field__31 was page_2_field_1 (0.36 conf)
page_field__32 was page_2_field_2 (0.36 conf)
page__3 was page_3_of_3 (0.42 conf)
left_home_person_suitable was left_at_home__with_person_of_suitable (0.45 conf)
mail was mail (0.38 conf)
hand_delivery was hand_delivery (0.35 conf)
e_filed was e_filed (0.48 conf)
email_person_agreed_service was email__person_agreed_to_service_by_email (0.42 conf)
left_business_person_charge was left_at_business__with_person_in_charge (0.48 conf)
page_check__5 was page_2_check_6 (0.26 conf)
page_check__6 was page_2_check_7 (0.26 conf)
page_check__7 was page_2_check_8 (0.26 conf)
page_check__8 was page_2_check_9 (0.26 conf)
page_check__9 was page_2_check_10 (0.26 conf)
page_check__10 was page_2_check_11 (0.26 conf)
page_check__11 was page_2_check_12 (0.26 conf)
page_check__12 was page_2_check_13 (0.26 conf)
page_check__13 was page_2_check_14 (0.26 conf)
page_check__14 was page_2_check_15 (0.26 conf)
page_check__15 was page_2_check_16 (0.26 conf)
page_check__16 was page_2_check_17 (0.26 conf)

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

Request to Assign a Court Visitor

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