Please complete the following Intake Form proir to your first meeting.

    General Information:

    (Date of Marriage/Cohabitation)

    (Date of Separation)

    Information About Opposing Party:

    Issues Disputed: (Check any that apply)

    Custody of the Children and Primary Residence of the Children?

    Access to the Children?

    Child Support?

    Does your Partner have Health/Dental/Medical Insurance?

    Special Expenses of the Children:

    Are the Children Enrolled in Extracurricular Activities?

    Do the Children have Health Needs?

    Are the Children Enrolled in a Full Time Program at College or University?

    Extraordinary (or Special Expenses) Payment Per Month?

    Spousal Support:

    Division of Property:
    Assets & Debts: (Enter Dollar Values)


    (Mortgage/Line of Credit/Credit Cards/Other Debts)