Enduring Guardianship Questionnaire

Your Details

Your full legal name

Your email address

Your phone number

Your address





Guardian's Details

How many guardians do you wish to appoint?

Your guardian's full legal name

Your guardian's email address

Your guardian's phone number

Your guardian's address




Their relationship to you (if any)


Second Guardian
Your second guardian's full legal name

Your second guardian's email address

Your second guardian's phone number

Your second guardian's address




Their relationship to you (if any)

For THREE guardians or more, please provide the additional details (same as above) of your other guardians in the comment section below.

Appointment

How do you want to appoint your guardians?
IndividuallyJointlyAlternatively

Individually or 'jointly and severally' means your guardians can act independently of each other.
Jointly means your guardians must act together.
Alternatively means your second guardian can only act if your first guardian is unable or unavailable to act.


Powers and Limitations

Do you want your guardian(s) to decide where you live?
YesNoNot sure

Do you want your guardian(s) to decide what health care you receive?
YesNoNot sure

Do you want your guardian(s) to decide what personal services you receive?
YesNoNot sure

Do you want your guardian(s) to decide what medical or dental services you receive?
YesNoNot sure

Do you want to limit your guardian(s) powers in any way? If so, list below.


General Comments

Additional Information

Would you also like to receive information about making an enduring power of attorney? The enduring guardianship only applies to your care and welfare, but it does not authorise your guardian to make decisions about your legal and financial matters. You must appoint an attorney with an enduring power of attorney to make deciaions about your legal and financial matters if you unable to make these decisions yourself.
Yes, please send me more information about making an enduring power of attorney.No, I do not want to receive more information at this time.

Would you also like to receive information about making or updating a Will? The power of a guardian is only relevant while you are still alive. If you have passed away, your guardian will no longer be authorised to do anything on your behalf. Your estate will be handled by your executor (if you have a Will) or an administrator (if you do not have a Will).
Yes, please send me more information about making or updating my Will.No, I do not want to receive more information at this time.