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Probate Court Administrative Order 2022-8 (Physician's Certificate of Medical Examination) — Galveston County. The operative requirements are quoted verbatim from the governing document (registered/posted 01/01/2023); the document in custody is the controlling text.
Texas > Galveston County > Probate Court
PROBATE COURT OF GALVESTON COUNTY, TEXAS ADMINISTRATION ORDER 2022-8 In accordance with the vote of all Judges of the Statutory Probate Courts in the State of Texas, the Physician's Certificate of Medical Examination (Exhibit A) form has been adopted for state wide use in all Statutory Probate Courts in the State of Texas. IT IS THEREFORE ORDERED that the Probate Court of Galveston County hereby adopts the Physician's Certificate of Medical Examination and ORDERS that effective immediately the Physician's Certificate of Medical Examination must be filed with all guardianship application that are filed in the Galveston County Probate Court. IT IS ALSO ORDERED this order will replace Administrative Order 2018-2 as a revised Physician's Certificate of Medical Examination (Exhibit A) has been created. This Order is effective as of the date it is entered. Signed: December 20, 2022 [signature] Kimberly Sullivan, Judge Presiding [File stamp: FILED 2022 DEC 20 PM 1:28, County Clerk, Galveston County, Texas] EXHIBIT A — Physician's Certificate of Medical Examination (Revision September 2015) In the Matter of the Guardianship of ______, an Alleged Incapacitated Person. [For Court Use Only — Court Assigned: ______] To the Physician: This form is to enable the Court to determine whether the individual identified above is incapacitated according to the legal definition (on page 3), and whether that person should have a guardian appointed. 1. General Information. Physician's Name ______; Office Address ______; Phone: ( ) ______. ☐ YES ☐ NO I am a physician currently licensed to practice in the State of Texas. Proposed Ward's Name ______; Date of Birth ______; Age ______; Gender ☐ M ☐ F. Proposed Ward's Current Residence: ______. I last examined the Proposed Ward on ______ 20__ at: ☐ a Medical facility ☐ the Proposed Ward's residence ☐ Other: ______. ☐ YES ☐ NO The Proposed Ward is under my continuing treatment. ☐ YES ☐ NO Before the examination, I informed the Proposed Ward that communications with me would not be privileged. ☐ YES ☐ NO A mini-mental status exam was given. If "YES," please attach a copy. 2. Evaluation of the Proposed Ward's Physical Condition. Physical Diagnosis: ______. a. Severity: ☐ Mild ☐ Moderate ☐ Severe. b. Prognosis: ______. c. Treatment/Medical History: ______. 3. Evaluation of the Proposed Ward's Mental Functioning. Mental Diagnosis: ______. a. Severity: ☐ Mild ☐ Moderate ☐ Severe. b. Prognosis: ______. c. Treatment/Medical History: ______. If the mental diagnosis includes dementia, answer the following: ☐ YES ☐ NO It would be in the Proposed Ward's best interest to be placed in a secured facility for the elderly or a secured nursing facility that specializes in the care and treatment of people with dementia. ☐ YES ☐ NO It would be in the Proposed Ward's best interest to be administered medications appropriate for the care and treatment of dementia. ☐ YES ☐ NO The Proposed Ward currently has sufficient capacity to give informed consent to the administration of dementia medications. d. Possibility for Improvement: ☐ YES ☐ NO Is improvement in the Proposed Ward's physical condition and mental functioning possible? If "YES," after what period should the Proposed Ward be reevaluated to determine whether a guardianship continues to be necessary? ______. 4. Cognitive Deficits. a. The Proposed Ward is oriented to the following (check all that apply): ☐ Person ☐ Time ☐ Place ☐ Situation. b. The Proposed Ward has a deficit in the following areas (check all areas in which Proposed Ward has a deficit): ☐ Short-term memory ☐ Long-term memory ☐ Immediate recall ☐ Understanding and communicating (verbally or otherwise) ☐ Recognizing familiar objects and persons ☐ Solve problems ☐ Reasoning logically ☐ Grasping abstract aspects of his or her situation ☐ Interpreting idiomatic expressions or proverbs ☐ Breaking down complex tasks down into simple steps and carrying them out. c. ☐ YES ☐ NO The Proposed Ward's periods of impairment from the deficits indicated above (if any) vary substantially in frequency, severity, or duration. 5. Ability to Make Responsible Decisions. Is the Proposed Ward able to initiate and make responsible decisions concerning himself or herself regarding the following: ☐ YES ☐ NO Make complex business, managerial, and financial decisions. ☐ YES ☐ NO Manage a personal bank account. If "YES," should amount deposited in any such bank account be limited? ☐ YES ☐ NO. ☐ YES ☐ NO Safely operate a motor vehicle. ☐ YES ☐ NO Vote in a public election. ☐ YES ☐ NO Make decisions regarding marriage. ☐ YES ☐ NO Determine the Proposed Ward's own residence. ☐ YES ☐ NO Administer own medications on a daily basis. ☐ YES ☐ NO Attend to basic activities of daily living (ADLs) (e.g., bathing, grooming, dressing, walking, toileting) without supports and services. ☐ YES ☐ NO Attend to basic activities of daily living (ADLs) with supports and services. ☐ YES ☐ NO Attend to instrumental activities of daily living (e.g., shopping, cooking, traveling, cleaning). ☐ YES ☐ NO Consent to medical and dental treatment at this point going forward. ☐ YES ☐ NO Consent to psychological and psychiatric treatment at this point going forward. 6. Developmental Disability. ☐ YES ☐ NO Does the Proposed Ward have developmental disability? If "NO," skip to number 7 below. If "YES," answer the following question and look at the next page. Is the disability a result of the following? (Check all that apply) ☐ YES ☐ NO Intellectual Disability? ☐ YES ☐ NO Autism? ☐ YES ☐ NO Static Encephalopathy? ☐ YES ☐ NO Cerebral Palsy? ☐ YES ☐ NO Down Syndrome? ☐ YES ☐ NO Other? Please explain ______. [Determination of Intellectual Disability box — completed only if the basis of the proposed ward's alleged incapacity is intellectual disability and the physician is making a Determination of Intellectual Disability in accordance with rules of the executive commissioner of the Health and Human Services Commission. Includes assessment of intellectual functioning and adaptive behavior (☐ Mild IQ 50-55 to approx. 70; ☐ Moderate IQ 35-40 to 50-55; ☐ Severe IQ 20-25 to 35-40; ☐ Profound IQ below 20-25), and evidence of origination during the developmental period. Note to attorneys regarding the 24-month and 120-day requirements under Texas Estates Code § 1101.104(1).] 7. Definition of Incapacity. For purposes of this certificate of medical examination, the following definition of incapacity applies: An "Incapacitated Person" is an adult who, because of a physical or mental condition, is substantially unable to: (a) provide food, clothing, or shelter for himself or herself; (b) care for the person's own physical health; or (c) manage the person's own financial affairs. Texas Estates Code § 1002.017. 8. Evaluation of Capacity. ☐ YES ☐ NO Based upon my last examination and observations of the Proposed Ward, it is my opinion that the Proposed Ward is incapacitated according to the legal definition in section 1002.017 of the Texas Estates Code, set out in the box above. If you indicated that the Proposed Ward is incapacitated, indicate the level of incapacity: ☐ Total — The Proposed Ward is totally without capacity (1) to care for himself or herself and (2) to manage his or her property. ☐ Partial — The Proposed Ward lacks the capacity to do some, but not all, of the tasks necessary to care for himself or herself or to manage his or her property. [Evaluation of Capacity continued: if partial, what specific powers or duties of the guardian should be limited if the Proposed Ward receives supports and services; explanations where Section 5 answers appear inconsistent with the incapacity finding.] 9. Ability to Attend Court Hearing. ☐ YES ☐ NO The Proposed Ward would be able to attend, understand, and participate in the hearing. ☐ YES ☐ NO Because of the Proposed Ward's incapacities, I recommend that the Proposed Ward not appear at a Court hearing. ☐ YES ☐ NO Does any current medication taken by the Proposed Ward affect the demeanor of the Proposed Ward or his or her ability to participate fully in a court proceeding? 10. What is the least restrictive placement that you consider is appropriate for the Proposed Ward: ☐ Nursing home level of care ☐ Assisted Living Facility ☐ Group Home ☐ Memory care unit ☐ Own Home or with family ☐ Other ______. 11. Additional Information of Benefit to the Court: If you have additional information concerning the Proposed Ward that you believe the Court should be aware of or other concerns about the Proposed Ward that are not included above, please explain on an additional page. Physician's Signature ______; Date ______; Physician's Name Printed ______; License Number ______. Revised September 2015.
PROBATE COURT OF GALVESTON COUNTY, TEXAS ADMINISTRATION ORDER 2022-8 In accordance with the vote of all Judges of the Statutory Probate Courts in the State of Texas, the Physician's Certificate of Medical Examination (Exhibit A) form has been adopted for state wide use in all Statutory Probate Courts in the State of Texas. IT IS THEREFORE ORDERED that the Probate Court of Galveston County hereby a
Reviewer note: Operative mandatory-language provisions quoted verbatim from the registered document; the full document (sha256 d97043753019…) is the controlling text. [TRANSCRIBED BY EYE 2026-09-21 (corpus-0920 P12): every page of the registered file (sha256 d97043753019..., 5 page(s), digital layer that failed the machine checks; text taken from the layer and corrected word by word from the page) read against the rendered file; verbatim, source typos kept, stamps/signatures bracketed; the earlier abstract replaced by the full instrument; confidence high. benchpath-tx-corpus0920-p12-2026-09-21]
Standing order of the 109th Judicial District Court for every pending or later-filed case in Andrews, Winkler and Crane Counties: any attorney or self-represented litigant who uses any form of artificial intelligence for legal research or drafting in a case must, before using AI-generated information in a court submission or proceeding, sign and submit the court's certification form stating that all language, quotations, sources, citations, arguments and legal analysis created or contributed to by generative AI were verified as accurate by a human through traditional (non-AI) legal sources, and acknowledging responsibility and potential sanctions for their or their co-counsel's failure to comply. Effective immediately; in effect until rescinded or replaced.
Standing order of the 109th Judicial District Court for every pending or later-filed case in Andrews, Winkler and Crane Counties: any attorney or self-represented litigant who uses any form of artificial intelligence for legal research or drafting in a case must, before using AI-generated information in a court submission or proceeding, sign and submit the court's certification form stating that all language, quotations, sources, citations, arguments and legal analysis created or contributed to by generative AI were verified as accurate by a human through traditional (non-AI) legal sources, and acknowledging responsibility and potential sanctions for their or their co-counsel's failure to comply. Effective immediately; in effect until rescinded or replaced.