Guardianship Petition Form - The Law Office of Randy Hope Steen, LTD.

Your Information

First Name(Required)

Middle Name

Last Name(Required)

Birth Date(Required)

Email(Required)

Phone Number(Required)

Your Current Address

Street(Required)

City(Required)

State(Required)

Zip Code(Required)

Child Information

Child's First Name(Required)

Child's Middle Name

Child's Last Name(Required)

Child's Birth Date(Required)

Child's Phone Number

Child's Email

Child's Primary Care Physician

Primary Care Physician Name

Primary Care Phone

Primary Care Physician Street Address

Official Diagnosis

Child's Address

Child's City

Child's State

Child's Zip Code

Child's Occupation

Child's Income

Child's Source of Income

Child's Location of Income

Child's Children

Legal Name

Address

Birth Date

Assets and Liabilities

We will need supporting document copies such as statements, deeds, notes and mortgages, partnership agreements, stock certificates, or policies.

Please list any assets or liabilities

Asset Type

Asset Location

Amount

Do you have anything else to tell us?

Referral Information

What is the name of the person who referred you?

What is the referrer's street address?

What is the referrer's city?

What is the referrer's state?

What is the referrer's zip?

The referrer is:

Attorney

Financial Planner

Previous Client

Other

Name of referring client:

If other, please explain:

Have you visited our website?

Yes

No

How can we improve our website?

Name

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Guardianship Petition Questionnaire