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The petition for determination of ability to give informed consent for sterilization shall be executed under oath and shall set forth:

(1) The name, age and residence of the respondent.

(2) The names and residences of any parents, spouse, legal guardian or conservator of the respondent.

(3) A statement of the facts describing the respondent’s alleged inability to give informed consent for sterilization.

(4) A statement of facts indicating the likelihood or unlikelihood that the respondent will have the ability to make an informed decision about sterilization in the foreseeable future.

(5) A statement of the reasons for which sterilization is sought.

(6) The name, position and statement of interest of the person initiating the petition or any person assisting the respondent with a self-initiated petition. [1983 c.460 §7]