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Home
About
Services
Guardianship
Divorce Mediation
Parenting Plans
Contract Disputes
Real Estate & Construction
Landlord-Tenant Mediation
Contact
Intake Form
Blog
Contact Us
Intake Form
Intake Form
Name
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Email Address
*
Phone Number
*
Address
Attorney
Attorney Email
Attorney Phone Number
Other Party Name
*
Other Party Email
*
Other Party Phone
*
Other Party Address
*
Married?
Yes
No
If Yes, How Long?
Separated?
Yes
Now
If Yes, How Long?
I Have Never Been Married
Yes
Do you Share Children?
Yes
No
If Yes, What are Their Names and Ages?
Case Type
Divorce
Parentage
Modification
Motion to Enforce
Has the case been filed in court?
Yes
No
If Yes, Who is the Petitioner?
If Yes, Now is the Respondent?
Case Number
Judge
Commissioner
Is there a Guardian Ad Litem?
Yes
No
If yes, what is Their Name?
Is there a Protective Order?
Yes
No
If yes, Please Attach a Copy
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What are the Main Issues You’d Like to Discuss in Mediation?
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