Forms

If you have decided to work with me, I will look forward to meeting with you. Depending upon the service you have chosen, I will ask you to complete certain forms. I can go over them with you in our initial meeting but they are listed here for your convenience. If you wish to complete them prior to our first session, please feel free to do so and bring them with you. 

1. For all services, a Client Information Sheet 
2. An Informed Consent Form for particular services
3. If needed, a signed Release of Information form

In addition, for Court Ordered Services I ask that you please send the court order in advance of our first meeting, or bring it with you to the first meeting. Further information about Court-Ordered Services is available below.

Also, if a retainer is required (in the Court Order and/or in the Informed Consent), I ask that you send a check for the retainer prior to our first session or bring it with you to the session.

  
INFORMED CONSENT 
It is important that you understand the nature of the particular service you are seeking and any limitations on confidentiality associated with it. Please read and sign the appropriate informed consent form for each of the following services:

Psychotherapy
Consultation
Confidential Mediation
Non-Confidental (Recommending) Mediation
Co-Parenting Counseling
Expert Review/Witness
Child Custody Evaluation


RELEASE OF INFORMATION
 
       In order to provide the most appropriate and effective service, it may also be important for me to exchange otherwise confidential information with other professionals. The following form is used for authorization to release and exchange confidential information:

Release of Information


COURT-ORDERED SERVICES

I
f Mediation or Co-Parenting Counseling services have been Court-Ordered, please bring the Court order to your first appointment.

Child Custody Evaluations
and Parenting Coordinator/Special Master appointments must
be Court-Ordered.
 

CHILD CUSTODY EVALUATIONS 
If you are beginning a Child Custody Evaluation, please send me the following, or bring to the first session:

1. A copy of the Court Order
2. A signed Informed Consent for a Child Custody Evaluation
3. The requested retainer
4. The Client Information Sheet
5. In addition, I will also ask that you complete a couple of questionnaires. You do not need to complete them prior to the first session; however, they are available here for your reference or if you wish to begin completing them: Parent Questionnaire ; "Your Child" Questionnaire

EXAMPLES OF STANDARD COURT ORDERS FOR CHILD CUSTODY EVALUATIONS
For Court-Ordered Child Custody Evaluations, the purpose, conditions, and scope of the evaluation should be described in a Court Order, which you should have signed and which should have been filed with the Court. For your reference, here are some standard Court forms for Child Custody Evaluations:

Order Appointing Child Custody Evaluator

Notice Regarding Confidentiality of Child Custody Evaluation Report

Child Custody Evaluation Information Sheet


PARENTING COORDINATOR/SPECIAL MASTER APPOINTMENTS
If I have been appointed Parenting Coordinator or Special Master in your case, please send me the following, or bring to the first session:

1. A copy of the Court Order
2. The requested retainer 
4. The Client Information Sheet

SAMPLE COURT ORDERS FOR PARENTING COORDINATOR/SPECIAL MASTER APPOINTMENTS
For the appointment of a Parenting Coordinator or Special Master, your attorney may be expected to draft a Stipulation and Order designed specifically for your situation. The following are sample drafts for specific Stipulations or Court Orders Appointing a Parenting Coordinator or Special Master:

Stipulation Appointing Parenting Coordinator1
Stipulation Appointing Parenting Coordinator2


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