Your First Name (required)
Your Last Name (required)
Your Email (required)
Phone
Home Address
Other Parent\'s name
Judge assigned to case
Your Attorney’s Name
Their attorney\'s Name
Children\'s Names and ages:
How long have you been separated/divorced?
Briefly describe the issues that are part of the conflict between you and the other parent
How many times have you been to Family Court Services or Family Court in the last 2 years?
Is there an attorney assigned to your children? Yes No
If yes, who is it?
Is there a psychological evaluation ordered or completed? Yes No
If yes. Who did it or is doing it?
Are there counselors involved for you, your children or the other parent? Yes No
If Yes, who are they, and which family member do they work with?
Is this a divorce or paternity case? Divorce Paternity
What is your current child sharing arrangement or court order for child sharing?
Is there anything else you would like us to know?
What would you like to take away from this program?
Informed Consent - The High Conflict Diversion Program is educational. It is not intended to be a substitute for family counseling or psychotherapy. Personal matters may be discussed during these classes and I agree to keep such matters confidential. No portion of the text, written or verbal presentations may be reproduced without the written consent of the Director, Brook D. Olsen.
By clicking \"I agree\" below, I hereby acknowledge that I have read and agree to the terms and conditions above.
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