How to Complete and File Ohio Form 17.1: Statement of Expert Evaluation

Ohio Form 17.1, the Statement of Expert Evaluation, is the standardized medical assessment a licensed physician or licensed clinical psychologist completes so an Ohio probate court can decide whether someone needs a guardian.¹ The form does not itself declare the individual incompetent. It gives the judge clinical evidence to weigh at the guardianship hearing. You download the form, hand it to the evaluator, and file the signed original with your guardianship application packet.

Where To Download the Form

The Supreme Court of Ohio publishes Form 17.1 on its guardianship forms page, and the PDF is hosted at the court’s Legal Resources site.²¹ Many county probate courts post a local copy, but the Supreme Court version is the statewide standard. Print enough copies to file the original with the court, serve one on the proposed ward, and keep one for your records.

Who Can Complete It

For a new guardianship application, only a licensed physician or a licensed clinical psychologist may complete Form 17.1.¹ A social worker, counselor, or nurse practitioner does not qualify at this stage. The evaluator must rely on personal examination and direct observation, not on a records review alone. The form itself requires “personal observations and prior history obtained during the examiner’s course of treatment / interaction with the individual.”

The eligible-evaluator pool widens later, once a guardian is already appointed and files a periodic guardian’s report under Ohio Revised Code 2111.49. At that stage a licensed independent social worker, licensed professional clinical counselor, developmental disability team, certified nurse practitioner, or licensed clinical nurse specialist may perform the evaluation.¹ That broader list does not apply to the original application.

The court will not pay for the evaluation unless a judge specifically orders it. Arrange payment with the evaluator up front.¹

What the Evaluator Fills In

Before you file, look through the returned form and confirm each section is answered. A vague or incomplete evaluation is the fastest way to have the court kick it back.

Identifying Information and Medical History

The proposed ward’s name and date of birth, the evaluator’s credentials and contact information, current medications with dosage and purpose, and any chronic physical conditions that affect daily functioning.¹

Mental and Cognitive Impairments

A checklist of nine areas: orientation, speech, motor behavior, thought process, affect, memory, concentration, comprehension, and judgment. For each, the evaluator marks Yes, No, or Unknown.¹ Every “Yes” needs a narrative description showing how the impairment appears in the person’s daily life. One-word answers are what get forms rejected.

Physical Impairments

A separate question covers physical limitations such as reduced vision, mobility, or hearing, and how those limitations affect self-care.¹

Recommended Living Situation

The evaluator picks from independent living, assisted living or group home, nursing home, memory care or lockdown unit, or another arrangement the evaluator specifies.¹ This recommendation feeds the court’s duty to consider less restrictive options, such as a limited guardianship or power of attorney, before ordering a full guardianship.³

Signature and Date

The evaluator signs and dates the form. The evaluation must be completed before the guardianship application is filed.¹ Many county courts treat the evaluation as stale if more than three months separate the examination date from the filing date. Check the date on the form before you file.

Filing With the Probate Court

You file Form 17.1 with the clerk of the probate court in the county where the proposed ward lives. It does not go in alone. It is part of a guardianship application packet, which typically includes:²

Form 17.0, Application for Appointment of Guardian of an Alleged Incompetent — the petition itself.
Form 15.0, Next of Kin of Proposed Ward, identifying close relatives who must receive notice.
Form 15.2, Fiduciary’s Acceptance, the proposed guardian’s written agreement to serve.
Form 15.3, Guardian’s Bond, unless waived by the court.
Form 15.9, Oath of Guardian, sworn at or before the hearing.

Some counties add local requirements such as a BCI background check or a credit report for guardians of the estate. Check the county probate court’s local rules before you file.

Filing fees vary by county. Some Ohio counties charge roughly $190 to $240 for an adult guardianship application, sometimes with an added hearing fee. Form 17.1 itself carries no separate court fee, but the evaluation cost — what the physician or psychologist charges — is on the applicant. Some counties accept electronic filing; others require in-person filing at the clerk’s window. Confirm the method before you go.

If the Proposed Ward Refuses the Examination

The process does not stop when the proposed ward will not cooperate. You can file a statement explaining that the person refused to submit to the evaluation, in place of a completed Form 17.1. The court can then appoint its own physicians, clinical nurse specialists, certified nurse practitioners, or other qualified professionals to examine or investigate the individual under Ohio Revised Code 2111.031.⁴ Those costs can be charged to the ward’s estate, the applicant, or, on a finding of good cause, the county.

What Happens After You File

Once the clerk accepts the packet, the court sets the case for hearing. Ohio law requires at least seven days’ written notice to the proposed ward, the applicant, and all next of kin before any guardian is appointed.⁵ No statute caps the outer limit, so scheduling depends on the county’s caseload. In busy urban courts, expect several weeks between filing and hearing.

A court investigator usually visits the proposed ward before the hearing to explain the person’s rights, ask questions about daily functioning, and write a report for the judge. That report and your Form 17.1 are the main evidence the court works from. The judge reads the evaluation to understand what the person can and cannot manage and whether something less than a full guardianship would meet the need. Under Ohio law, “incompetent” means a person so mentally impaired — from mental or physical illness, intellectual disability, or chronic substance abuse — that they cannot properly care for themselves or their property.⁶

Form 17.1 Comes Back Later

The form is not a one-time filing. After a guardian is appointed, Ohio Revised Code 2111.49 requires periodic guardian’s reports that include a fresh expert evaluation confirming the guardianship is still necessary.¹ For those reports, the evaluation must occur within three months before the report is filed, and the wider list of eligible evaluators applies, so a guardian does not need to schedule a physician visit each time.

1
Supreme Court of Ohio. Form 17.1 – Statement of Expert Evaluation
2
Supreme Court of Ohio. Guardianship Forms
3
Ohio Legislative Service Commission. Ohio Code 2111.02 – Appointment of Guardian
4
Ohio Legislative Service Commission. Ohio Code 2111.031 – Appointing Physicians and Other Persons to Determine Need for Guardianship
5
Ohio Legislative Service Commission. Ohio Code 2111 – Guardians and Conservatorships
6
Ohio Legislative Service Commission. Ohio Code 2111.01 – Definitions