In Camera Child Custody Interview Request Form
Request an in camera child custody interview for a child custody matter by providing case, child, scheduling, and contact details.
Requesting Party Information
Full Name
*
First Name
Middle Name
Last Name
Relationship to Child
*
Please Select
Parent
Legal Guardian
Grandparent
Other Relative
Attorney
Social Worker
Other
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Case and Child Details
Case or Docket Number
*
Child's Full Name
*
First Name
Middle Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Court / Jurisdiction or Hearing Location
*
Interview Request Details
Reason for Interview Request
*
Preferred Interview or Hearing Date/Time
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Special Scheduling Notes or Availability Constraints
Preferred Interview Format/Location
In chambers
Private interview room
Other
Submission and Authorization
Confirmation
*
I affirm that the information provided is accurate and complete
I understand this is only a request for an in camera child custody interview
Requester Signature
*
Submit Request
Submit Request
Should be Empty: