Short Answer

North Carolina does not require a specific doctor’s form to file a guardianship (incompetency) petition. You must prove incompetency with clear, cogent, and convincing evidence, which often includes recent medical records, treating‑provider testimony, and, when helpful, a court‑ordered multidisciplinary evaluation. If you are transferring an existing out‑of‑state guardianship to North Carolina, medical proof is usually not re‑litigated; the Clerk focuses on proper transfer/registration and current suitability unless a new adjudication is requested.

Understanding the Problem

You want to know what medical proof you need to file or transfer a guardianship in North Carolina. The Clerk of Superior Court decides incompetency and, if needed, appoints a guardian. You’re asking what evaluations and records you should present now that your loved one has lived in North Carolina for years and already has a guardianship from another state administered by a sibling.

Apply the Law

In North Carolina, the petitioner must prove the respondent is incompetent under Chapter 35A before a guardian is appointed, unless an existing out‑of‑state guardianship is accepted/registered under Chapter 35B. The Clerk of Superior Court is the forum. The rules of evidence apply at the incompetency phase, and the burden of proof is clear, cogent, and convincing. Medical affidavits may be used in uncontested matters; contested cases typically require live testimony or admissible records. A multidisciplinary evaluation (MDE) is optional and can be ordered on a written request filed shortly after service of the petition; it must be completed promptly and filed with the Clerk. The petition must also explain what less restrictive alternatives were considered and why they are insufficient.

Key Requirements

• Competent evidence of incapacity: Recent medical records, clinician opinions, and functional evidence showing the person cannot manage affairs or make/communicate important decisions.
• Multidisciplinary evaluation (if ordered): A court‑authorized assessment by qualified professionals addressing capacity, diagnoses (e.g., dementia), functional limits, supports, and recommended scope of guardianship.
• Rules of Evidence apply: In contested hearings, hearsay (like unsworn letters) may be excluded; have providers available or use admissible records.
• Less restrictive alternatives: The petition must state what alternatives (e.g., representative payee, powers of attorney, supported decision‑making) were tried or considered and why they won’t meet the person’s needs.
• Transfer from another state: If using Chapter 35B to accept/recognize an out‑of‑state guardianship, provide certified orders/letters; the Clerk typically does not re‑try medical incapacity unless a new NC adjudication is sought.

What the Statutes Say

• North Carolina Gen. Stat. § 35A-1111 (Multidisciplinary evaluation) – Allows the Clerk to order an MDE; sets timing and handling of the evaluation.
• North Carolina Gen. Stat. § 35A-1112 (Hearing; adjudication) – Requires proof by clear, cogent, and convincing evidence; rules for the hearing.
• North Carolina Gen. Stat. § 35A-1106 (Petition contents) – Lists what must be in the petition, including less restrictive alternatives considered.
• North Carolina Gen. Stat. § 35B-17 (Jurisdiction under UAGPPJA) – Addresses which state’s court may act; relevant when moving a guardianship between states.

Analysis

Apply the Rule to the Facts: Because there is an existing guardianship from another state and the person has lived in North Carolina for years, you have two paths. If you transfer/accept the out‑of‑state guardianship under Chapter 35B, the Clerk usually relies on certified copies of the prior order/letters and does not re‑litigate medical incapacity. If you instead seek a new NC adjudication, gather recent medical records, consider asking for an MDE, and be prepared to present admissible provider testimony or records to meet the clear, cogent, and convincing standard.

Process & Timing

1. Who files: Any interested person. Where: Clerk of Superior Court in the North Carolina county of the respondent’s residence. What: AOC‑SP‑200 (Petition) and, if required locally, AOC‑SP‑208 (Guardianship Capacity Questionnaire). For transfer/acceptance, file certified copies of the out‑of‑state order and current letters. When: File after you have recent medical records and, if you want an MDE, be ready to request it promptly after service.
2. The Clerk appoints a guardian ad litem; the sheriff personally serves the respondent and notices other required persons (including any current out‑of‑state guardian). If an MDE is desired, file a written request soon after service; the evaluator files the report within roughly 30 days of the Clerk’s order. Contested matters may require subpoenaed provider testimony.
3. At hearing, the Clerk decides incompetency (unless accepting a transfer) and, if appropriate, appoints a guardian and issues orders/letters. For transfer, the Clerk enters an order accepting the out‑of‑state guardianship and issues North Carolina letters without re‑trying medical incapacity.

Exceptions & Pitfalls

• In contested hearings, unsworn letters can be excluded as hearsay. Line up live provider testimony or use admissible medical records.
• For dementia/elderly cases, bring recent cognitive assessments and functional descriptions (ADLs, medication management, safety risks) to define whether a limited or general guardianship is needed.
• Obtain HIPAA releases early so you can collect records in time; the guardian ad litem will expect up‑to‑date documentation.
• When transferring from another state, provide certified orders/letters and notify the existing guardian; acceptance generally focuses on proper transfer and current suitability, not re‑proving incapacity.
• Out‑of‑state or nonresident proposed guardians may be required to post bond; discuss this with the Clerk in advance.

Talk to a Guardianship Attorney

If you’re dealing with medical proof for a North Carolina guardianship or transferring one from another state, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.