Utility Links
Illinois.gov
Bruce Rauner, Governor
About IGAC
Contact Us
Skip to Content
Toggle navigation
It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again.
GAC
Home
About Us
Meet the Commissioners
Executive Management Team
Regional Offices
Employment Opportunities
Meeting Notices and Agendas
Statutes
Divisions
Office of State Guardian
Legal Advocacy Service
Human Rights Authority
Volunteer
Currently selected
Mission Statement
Online Volunteer form
Training Module 1
Training Module 2
Ward Visit Form
Advance Directives
Forms & Advance Directives
Guardian of a Person
Probate Forms
Breadcrumb
GAC
Office of State Guardian
Ward Visit Form
indicates required field
Volunteer Name
Volunteer Email
Ward Name
Facility
Date of Visit
Visit Location
Length of Visit
(in minutes, including time spent with staff and reviewing records)
Appearance of the Ward
(Check all that apply)
Neat
Unkempt
Clean
Dirty/Stained Clothes
Dressed Inappropriately
Dressed Appropriately
Ambulates without assistance
Ambulates with cane
Ambulates with walker
Ambulates with wheelchair
Mood of the ward
(Check all that apply)
Appropriate
Angry/Hostile
Troubled, Sad, or Depressed
Thought Content Inappropriate
Short Attention Span
Unable To Determine
Interaction Active
Interaction Passive
Did the ward asknowledge your presence?
Yes
No
Was the ward doing any Activities?
Yes
No
Was the ward satisfied with the staff?
Yes
No
Was the staff available to answer questions?
Yes
No
Was the ward satisfied with the care?
Yes
No
Please provide a brief narrative describing your visit.
(Including descriptions to your answers above. What did you and your ward do? What did you talk about? Any specific concerns of progresses?) Please type in all lower case for data entry purposes
Leave Blank
Page Content
Office of State Guardian
Currently selected
OSG Regional Offices
OSG Service Profile
DNR
Practitioners Guide to Adult Guardianship in Illinois
FAQ
Guide to adult guardianship in Illinois
Guardianship Fact sheet
Guardianship FAQ
Guardianship Training
Online intake form
OSG Case Law
OSG Links
Volunteer guardianship advocate program information and tools