What type of communication do you have with the other parent? *
Attorney Contact Information: name, email, phone number *
Your answer
Guardian ad Litem Contact Information: name, email, phone number *
Your answer
Parenting Consultant contact information: name, email, phone number
Your answer
Why is supervised parenting time requested and what are the primary concerns? *
Your answer
Please note any concerns regarding the health, welfare, and safety of the child (ren) *
Your answer
What are the payment arrangements?
Your answer
Are there any of the following Orders in place between the parents? If yes, please send a copy of the Order.
Clear selection
Are any of the following Orders in place that includes the child (ren), if yes, please send a copy of the Order.
Who will be transporting the child (ren) to and from the visits? Please note anyone other than the parent. Name, relation to the child (ren), phone number *
Your answer
Are there any previous or active court orders restricting contact between parents and or children If so, please attach. *
Date of most recent Order *
MM
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YYYY
Is there an upcoming court date? If so, please note the date and time *
MM
/
DD
/
YYYY
Anything not covered that would be helpful for me to know?