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 respondents 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.
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