Family Interview

Information about children

Child #1 Full Name

Child #1 Gender

Child #1 Date of Birth

Child #1 currently lives with

Other

Child #2 Full Name

Child #2 Gender

Child #2 Date of Birth

Child #2 currently lives with

Other

Child #3 Full Name

Child #3 Gender

Child #3 Date of Birth

Child #3 currently lives with

Other

Child #4 Full Name

Child #4 Gender

Other

Child #4 Date of Birth

Child #4 currently lives with

Other

Child#1 Name Name Year of Birth DOB Gender

Child#2 Name: Name Year of Birth DOB Gender

Child#3 Name: Name Year of Birth DOB Gender

Child#4 Name: Name Year of Birth DOB Gender

Child#5 Name: Name Year of Birth DOB Gender

Please type the names, year of birth, and gender for additional children:

Please list the children who were not legally adopted by the husband or are not the husband's biological children (include children born after you already separated):

What type of custody and visitation do you want?

Have there been any other court cases involving the children (protective orders, custody orders, guardianship)?

If there is someone other than the parents who has custody or guardianship over any of your children, please list the custodian/guardian's name, address and phone number:

Information about the Opposing Counsel