Temporary Guardianship Emergency Petition Form
Petitioner(s) Name(s)
Address
City
State
Zip Code
Phone
Email
Child(ren) Name(s)
Date of Birth
Relationship to Petitioner(s)
Proposed Guardian(s) Name(s)
Address
Phone
Email
Relationship to Child(ren)
Reason(s) for Emergency Petition
Current Location of Child(ren)
Date Child(ren) Placed with Proposed Guardian(s)
Parent(s)/Legal Guardian(s) Name(s) and Address(es)
Are parent(s)/legal guardian(s) aware of this petition?
If not, explain why:
Additional Information