INSTRUCTIONS: CALIFORNIA PETITION FOR EXCLUSIVE AUTHORITY TO GIVE CONSENT FOR MEDICAL TREATMENT (Form GC-380)

The form discussed in this article is used to request exclusive authority to give consent for medical treatment of a California conservatee. This document can be obtained from the website maintained by the California Judicial Board.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 1: In the first blank box, enter the name of the attorney, as well as their state bar number, address, telephone number, fax number and name of the represented party. If you have no attorney, enter the applicable information for yourself.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 2: In the second blank box, enter the county, street address, mailing address, city and zip code, and branch name of the court being petitioned.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 3: In the third blank box, indicate whether this petition concerns a person or estate with a check mark.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 4: Enter the name of the conservatee.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 5: In the fourth blank box, enter the case number.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 6: On line 1, enter the name of the petitioner.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 7: On line 1c, indicate with a check mark whether you are requesting that treatment be performed by a licensed medical practitioner, a licensed psychologist within the scope of his or her licensure, or an accredited practitioner of a religion relying on prayer alone for healing.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 8: Check the box on line 1d if requesting orders related to dementia treatment or placement.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 9: On line 1e, if applicable, enter the date of the order you wish to have revoked, modified as specified in attachment 1e or as specified below. Indicate which with a check mark.

California Petition For Exclusive Authority To Give Consent For Medical Treatment GC-380 Step 10: Complete the rest of the form as instructed.