INSTRUCTIONS: CALIFORNIA ATTACHMENT TO FORM GC-335, CAPACITY DECLARATION — CONSERVATORSHIP, ONLY FOR (PROPOSED) CONSERVATEE WITH DEMENTIA (Form GC-335A)

The form discussed in this article is filed along with form GC-335 in California if a proposed conservatee may have dementia and gives an evaluation of their condition. This document can be obtained from the website maintained by the California Judicial Branch.

California Attachment To Form GC-335, Capacity Declaration — Conservatorship, Only For (Proposed) Conservatee With Dementia GC-335A Step 1: Check the first box if this concerns conservatorship of a person.

California Attachment To Form GC-335, Capacity Declaration — Conservatorship, Only For (Proposed) Conservatee With Dementia GC-335A Step 2: Check the second box if this concerns conservatorship of an estate and enter the name of the person whose estate it is.

California Attachment To Form GC-335, Capacity Declaration — Conservatorship, Only For (Proposed) Conservatee With Dementia GC-335A Step 3: Check the third box if this concerns conservatorship of a conservatee.

California Attachment To Form GC-335, Capacity Declaration — Conservatorship, Only For (Proposed) Conservatee With Dementia GC-335A Step 4: Check the fourth box if this concerns conservatorship of a proposed conservatee.

California Attachment To Form GC-335, Capacity Declaration — Conservatorship, Only For (Proposed) Conservatee With Dementia GC-335A Step 5: Where indicated, enter the case number.

California Attachment To Form GC-335, Capacity Declaration — Conservatorship, Only For (Proposed) Conservatee With Dementia GC-335A Step 6: On line 9, indicate with a check mark whether it is your opinion that the conservatee or proposed conservatee has or does not have dementia.

California Attachment To Form GC-335, Capacity Declaration — Conservatorship, Only For (Proposed) Conservatee With Dementia GC-335A Step 7: Check the box on line 9a if the conservatee or proposed conservatee requires placement in a secured-perimeter residential care facility for the elderly. If so, state why they would benefit from this placement on sub-line 1.

California Attachment To Form GC-335, Capacity Declaration — Conservatorship, Only For (Proposed) Conservatee With Dementia GC-335A Step 8: On sub-line 2, detail the mental function deficits of the conservatee or proposed conservatee.

California Attachment To Form GC-335, Capacity Declaration — Conservatorship, Only For (Proposed) Conservatee With Dementia GC-335A Step 9: Check sub-line 3 if the proposed conservatee or conservatee has capacity to give informed consent to placement. If not, check sub-line 4. Complete the rest of the form as instructed.