Parenting [Coordination/Facilitation] Services Information Sheet
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Court cause no. |
Judge ordering |
|
County |
Marriage date |
|
Date of separation |
Date of divorce |
|
Date ordered |
Next scheduled hearing date |
PARTY A:
Name
Address
Phone (home) ________________ (work) ________________ (cell)
Fax ________________ E-mail
PARTY B:
Name
Address
Phone (home) ________________ (work) ________________ (cell)
Fax ________________ E-mail
PARTY A’S ATTORNEY:
Name
Address
Phone ______________ Fax ______________ E-mail
PARTY B’S ATTORNEY:
Name
Address
Phone ______________ Fax ______________ E-mail
CHILD[REN]:
Name Date of birth With whom primarily residing
CHILD[REN]’S ATTORNEY(S):
Name
Address
Phone ______________ Fax ______________ E-mail
OTHER PARTY:
Name
Address
Phone ______________ Fax ______________ E-mail
LEGAL DECISIONS PENDING: __ Predivorce or __ Postdivorce or __ Never married
____ Dissolution of marriage
____ Spousal maintenance:
____ Property settlement:
____ Child support:
____ Conservatorship:
____ Parent to establish primary residence:
____ Parental access:
____ Relocation:
____ Modification:
____ Enforcement:
Send to: [name of parenting coordinator or facilitator], [fax number of parenting coordinator or facilitator]
For information: call [phone number of parenting coordinator or facilitator] or
e-mail [e-mail address of parenting coordinator or facilitator]
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Attach a copy of the order or relevant part of the order appointing the parenting coordinator or facilitator and describing the appointee’s duties. |