Child Custody Mediation Checklist Form
Please complete this form to help prepare for your upcoming child custody mediation. This will assist in organizing key information and documents relevant to your case.
Full Name of Parent or Guardian
*
First Name
Last Name
Email Address
*
example@example.com
Names and Ages of Children Involved
*
Current Custody Arrangement
*
Joint Physical Custody
Sole Physical Custody
Joint Legal Custody
Sole Legal Custody
Other
Briefly describe your goals for mediation
*
Availability for Mediation Sessions (select all that apply)
*
Weekday mornings
Weekday afternoons
Weekday evenings
Weekends
Other
Have you prepared the following documents? (check all that apply)
Parenting plan proposal
School records
Communication logs
Childcare schedules
Other relevant documents
Please list any additional topics or concerns you wish to discuss during mediation
Preferred method of contact for mediation updates
*
Email
Phone
Submit
Should be Empty: