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Request a Treatment Guardian

In order to request a Treatment Guardian, please use the form provided below.

Honor Guardianship will review the information provided and supply an appropriate Treatment Guardian. 

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It is the responsibility of the requestor to petition the Courts for a hearing on the matter. 

This process is separate from requesting a Treatment Guardian.

 

A Treatment Guardian can be appointed for a maximum of 12 months. 

Once the appointment expires, another appointment may be made if it is deemed necessary by the patient's treatment team.

Patient Demographic Information
Sex
Is there a history of violence?
Is there a diagnosis of polysubstance abuse?
If Yes, please select:
Next of Kin / Alternate Contact

Requestor Information
Patient is currently:

Note: "Requestor" refers to the person filling out this form.

Are you the facility's primary point of contact for the patient?

Note: If the following fields are not filled out,

requestor will be considered the primary point of contact.

If No, who is the facility's primary point of contact for the patient?

Has a petition for TG already been filed?
Please allow up to 24 business hours for your request to be processed.
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