HomeMy WebLinkAbout08-04-09 (2)IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
No. c~ l - a~'" 070
ESTATE OF THEODORE SYPHAX
AN ALLEGED INCAPACITATED PERSON
PETITION UNDER §5511 OF THE PROBATE,
ESTATES AND FIDUCIARIES CODE TO ADJUDGE
THEODORE SYPHAX TO BE TOTALLY INCAPACITATED
AND APPOINT A GUARDIAN FOR THEODORE SYPHAX'S PERSON AND ESTATE
WRITTEN INTERROGATORIES OF JAMES HARTY, M.D.
Q. State your name and your office address.
Q. State the schools you have attended, the academic and professional degrees you have
received, and the dates of your receipt of such degrees.
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Q. How long have you practiced your profession?
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Q. State the names of the Pennsylvania licensing agencies which have issued licenses to you
so as to enable you to practice your profession, and state the dates of the issuance of the
licenses.
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Q. Have you, or has any medical professional examined, interviewed or tested Theodore
Syphax?
A. Y~ s
Q. State the dates on which you last examined, interviewed or tested Theodore Syphax.
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Q. State the nature of such examination, interviews or tests referred in the preceding
questions.
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Q. Have you regularly treated Theodore Syphax? If so, how long have you treated him?
Q. What is Theodore Syphax's age and date of birth?
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Q. In your opinion, is his ability to receive and evaluate information effectively and
communicate decisions impaired to such a significant extent that he is partially or totally
unable to manage his financial resources or to meet the essential requirements for his
physical health and safety? If so, is the impairment partial or total?
A. y{ s .
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Q. State the nature and extent of Theodore Syphax's incapacities and disabilities and his
mental, emotional and physical condition; adaptive behavior; and social skills.
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Q. What services are being utilized to meet the essential requirements for Theodore
Syphax's physical, health and safety, to manage his financial resources, or to develop or
regain his abilities?
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Q. What types of assistance does he require, and why would no less restrictive
alternatives be appropriate?
Q. What is the probability that the extent of Theodore Syphax's incapacities may
significantly lessen or change?
A.
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Q. State the reasons for your answer to the immediately preceding question.
A.
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Q. Would his physical or mental condition be harmed by his presence at the hearing on the
issue of his alleged incapacity?
A. Y~.s
Q. State the reasons for your answer to the immediately preceding question.
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James Harty, .D.
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AFFIDAVIT
COMMONWEALTH OF PA
SS
COUNTY OF CUMBERLAND
James Harty, M.D., being duly sworn according to law, deposes and says that the
Answers set forth in the foregoing Interrogatories are true and correct to the best of his
knowledge, information or belief.
.~r1.O
James arty, M.
SWORN TO AND SUBSCRIBED
before me his ~_ day
of ~t~.~l,, , 2009
Notary Public
NOTARIAL SEAL
NINA M FERRY
Notary Public
sWf~UEMANNA TWP..tUNU1TA COUNIY
My Commisgon MOy~ Z4. ZOl t
:711994.1
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