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Welcome
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Why Mediation
Process
FAQ
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First name
*
Last name
*
How Many Children?
*
Child 1 Full Name
*
Child 1 Date of Birth
*
Month
Month
Day
Year
Child 1 Gender
*
Male
Female
Other
Are any of the children above in school (VPK or above)?
*
Yes
No
Do you celebrate any of the following holidays (and consider important enough to change your child(ren)’s regular timesharing schedule)?
*
Mother's Day
Father's Day
Martin Luther King Day
Easter
Passover
Memorial Day
July 4th
Labor Day
Columbus Day
Halloween
Thanksgiving
Veteran's Day
Hanukkah
Yom Kippur
Rash Hashanah
Christmas
New Year's
Other
Please describe your work schedule with specificity. If it varies, please try to explain the variance as best as possible.
*
Do any of the children listed above have special needs?
*
Yes
No
Please describe any issues you have with the other party in making important decisions with respect to your child(ren).
Do you and the other party use a co-parenting app (Our Family Wizard, Talking Parents, AppClose, etc.) to communicate issues involving any of the children listed above?
Please select any insurance you have for your child(ren).
Medical
Dental
Vision
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