Child Custody and Visitation Contact Form

*First Name

*Last Name

*Email Address

*Phone Number

*Zip

Street Address

Apt/Ste

Incident Street Address

Incident Apt/Ste

*Incident Zip

How many children do you have and what are their ages?

Have you started divorce proceedings yet?
Yes  No 

Have you physically separated from your spouse?
Yes  No 

With whom do the children live?

Have you worked out any temporary arrangements regarding child custody and visitation?
Yes  No 

Does your former spouse engage in any behavior that puts your children at risk?
Yes  No 

Do either you or your former spouse intend to relocate to another state at any time in the near future?
Yes  No 

Have any temporary or permanent custody and visitation orders already been entered in your divorce case?
Yes  No 

Have you met with any non-legal professionals like mediators or parenting coaches yet in an effort to resolve disputed custody issues?
Yes  No 

Has a custody evaluation been ordered or completed in your case?
Yes  No 

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