Legalgen

Welcome and Registration

Welcome to the Summary of Wishes application. This process will take approximately 15 minutes. By starting your application, you’ll automatically be registered with a login and password—allowing you to save your progress and return later to make updates if needed.

Purpose of This Summary This summary is intended to provide guidance to those who will have a role of great importance as guardian, caregiver, or trustee for our child in the event of our death or incapacity. It represents the vision we have for our child and includes meaningful details to support those entrusted with their care. While not every circumstance can be predicted, this document reflects our heartfelt wishes and should be considered binding to the greatest extent possible.

We ask that guardians follow the values expressed here concerning our child’s: Personal care and nurturing, Education, Spiritual development and Social growth. Trustees are asked to fully support the guardian to carry out this vision effectively.

Getting Started

Please complete the form below with your name, email, and contact number to begin. Once registered, you will be guided step-by-step through the application. If you need to pause, you may return at any time. Thank you for your care and attention in helping preserve our child’s well-being, continuity, and connection with loved ones.

First Name *

Middle Name

Last Name *

Email *

Password

Phone

Initial Instructions - Appointed Guardian

Upon our death or incapacity, our child will become the responsibility of the appointed guardian, identified as follows:y turn 18. If you have step children, then the surviving bioligical parent is presumed to be guardian, unless their rights have been legally teminated. You can overwrite primary Guardian.

Primary Guardian

Email

Phone

Address

Appointed By The Court?

✓

Yes

✓

No

Family Members, Friends, And Organizations

Upon our death or incapacity, and as soon as our child is placed in the custody of their guardian, please notify the following family members, friends, and organizations of our death or incapacity, and of the location of our child:

Name Click the "+" button to add another individual.

Relationship Type:

Phone:

Work Phone:

Address:

Getting to Know Our Child

Telling Our Child

Details About Our Child’s Living Situation

Advocacy

Important Details Regarding Family Involvement

Our Vision For Our Child’s Religious & Spiritual Growth

Our Educational Preferences For Our Child

Activities & Recreation

Discipline

Financial Needs

All About Our Child

The following information is a snapshot about our child’s community involvement:

Job

Name/Position

Weekly Schedule

Location

Comments

Goal(s) of These Community Roles

Attach your child’s Individual Education Plan (IEP) or Individual Support Plan (ISP), if applicable

Trustee

Provide the legal name of your trustee to administer the trust that will be created for your beneficiaries:

Would you like your Primary Trustees to serve jointly? *

✓

Yes

✓

No

Primary Trustee: *

Serve Jointly

Online Accounts

The following are online accounts our child has (social media, companies, banks):

Name *

Username *

Password *

Comments *

Spouse Trustee

Would you like your Primary Trustees to serve jointly? *

✓

Yes

✓

No

Primary Trustee: *

spouse_Serve Jointly

Routine

The following information gives insight into our child’s daily schedule:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Personality Traits & Preferences

Personality Traits & Preferences

Children Personal Information

The following personal information will be helpful at the time of our death or incapacity, and may be useful to our child and their caregiver in the future:

Our Child

Name *

Full Street Address *

Social Security Number

Date Of Birth

Phone Number

Email Address *

Parents Information

The following personal information will be helpful at the time of our death or incapacity, and may be useful to our child and their caregiver in the future:

Parents

Father’s Name *

Full Street Address *

Social Security Number

DOB and/or DOD (if applicable)

Phone Number

Email Address *

Mother’s Name *

Social Security Number

Full Street Address *

DOB and/or DOD (if applicable)

Phone Number

Email Address *

Trustee(s) of the Supplemental Needs Trust

The following personal information will be helpful at the time of our death or incapacity, and may be useful to our child and their caregiver in the future:

Trustee’s Name *

Relationship Type: *

Full Street Address *

Social Security Number *

Phone Number *

Email Address *

Contacts

Individuals, organizations, professional groups, government agencies, or other important contacts providing or coordinating services for our child are provided in order that a seamless communication exist that will allow a smooth transition for our child, and all concerned.

Organization Name *

Relationship Type: *

Full Street Address *

Phone Number *

Email Address *

Services Provided/ Comment *

Medical Information

Professional’s Name *

Phone Number/Fax *

Address *

Specialty *

How often do you go? *

Comments *

Financial DPOA-Spouse/Partner

Primary Agent: *

Phone Number *

Address *

Primary Insurance Information

Medicare Number

Medicare Compliment

Medicaid Number

Health Insurance Provider

Policy Number

Group Number

Secondary Insurance Information (if applicable)

Health Insurance Provider

Policy Number

Group Number

Contact Information

Health Care POA - Spouse/Partner

Please provide the information of one or more individuals who will serve as your health care agent:

Do you wish to use the same agents as your Power of Attorney? *

✓

Yes

✓

No

Primary Agent: *

Phone Number *

Address *

Tertiary Insurance Information (if applicable)

Health Insurance Provider

Policy Number

Group Number

Contact Information

Medical History

The following is our child's medical history information:

Diagnosis *

Diagnosis Definition *

Doctor/ Year Diagnosed *

Treatment/ Medication *

How it Affects Daily Life *

Prescription Medication

The following prescription medication(s) are currently used:

Medication Purpose *

Dose/ Frequency *

Doctor/ Date *

Side Effects Noted *

Comments: *

Non-Prescription Medication

The following non-prescription medication(s) are currently used:

Medication Purpose *

Dose/ Frequency *

Side Effects Noted *

Comments: *

Equipment/Assistive Technology

The following equipment and/or assistive technology devices are currently used:

Name Purpose *

Directions on How to Use *

Comments: *

Income

The following information relates to all income that our child receives:

Supplemental Security Income (SSI) *

Social Security Disability Income (SSDI): *

Employment *

Veteran’s Benefits *

Pension *

Other *

Assets

The following information relates to all assets available to our child:

Bank Account

Bank Account *

ABLE Account *

Disbursements from a Trust *

Comments about These Disbursements *

Real Estate

Regular Gifts from a Parent/Family Member *

Savings Bonds, CDs, Annuities, Mutual Funds, Stocks, etc. *

Other *

Financial Information

The following identifies our child’s financial account information:

Financial Institution *

Address *

Type of Account *

Phone Number/Fax *

Pin Numbers and/or Passwords *

Type of Account *

Funds Are To Be Used For *

Estate Planning Documents

The following identifies the legal documents our child has established:

Financial Power of Attorney :

Appointed Agent *

Where Document is Stored *

Agent’s Address *

Relationship *

Health Care Power of Attorney

Appointed Agent *

Agent’s Address *

Phone Number *

Email *

Where Document is Stored *

Realtionship *

Estate Planning Documents Continued

The following identifies the legal documents our child has established:

Mental Health Power of Attorney

Appointed Agent *

Where Document is Stored *

Agent’s Address *

Relationship *

Living Will

Appointed Agent *

Agent’s Address *

Phone Number *

Email *

Where Document is Stored *

Realtionship *

Wishes for Medical Treatment *

Executor - Spouse/Partner

Primary Executor *

Estate Planning Documents Continued Two

The following identifies the legal documents our child has established:

Last Will and Testament

Important Wishes Stated in This Document *

Where Document is Stored *

Beneficiary Information

Our child is named as a beneficiary on the following accounts:

Type of Account *

Where Held *

Additional Information

Additional Information provided

Miscellaneous Information *

Submission Screen

If you would like to review your responses, please review your responses on the right hand side on the specific screens. After you click submit, you will be finished and we will email your answer and the office will contact you with the next steps .

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Your Progress