Intake Form 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) (RRSP/Pension/Jewelry/Vehicles) (Mortgage/Line of Credit/Credit Cards/Other Debts)