• Parenting Coordination Intake Form

  • This intake form takes about 10 minutes to complete and provides your Parenting Coodinator with some basic background information for the purposes of administration and preparation. The information collected is treated in the strictest of confidence and is not shared with the other party. However, due to the non-confidential nature of Parenting Coordination, the information may be requested by the Court for any possible ongoing or future litigation.

    Please have any relevent Court Orders or Parenting Plans ready to upload.  

    Should you have any questions or require any assistance, please do not hesitate to call our team on 1300 164 164 or email us at admin@separationsolutions.com.au

  • Personal Details

  • IMPORTANT: Please note this email address will be used in communications from us and your Parenting Coordinator to the other party. If you do not wish the other party to have this email address, please nominate an alternate address.

  • Format: 0400 000 000.
  • Do you currently have legal representation?*

  • Background

  • Have you previously participated in any Parenting Coordination?*
  • How have you been directed to attend Parenting Coordination?*
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  • Are the orders?*
  • Is the parenting plan?

  • Relationship & Family Details

  • Details of children*
    Rows

  • Safety & Risk

  • Are there any current allegations of risk to a party or child in the case?*
  • Are there any current ADVO or protection orders in place between the parties?*
  • In the past 6 months, have you in any way been frightened of, or concerned for your own safety because of the other party?*
  • Are you currently afraid for your own safety because of the other party?*

  • Communication & Conflict

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  • Over the past 6 months, how often did you and the other parent discuss and agree on decisions about your children?*
  • Over the past 6 months, how often did you and the other parent have angry disagreements?*
  • Has your child/ren ever heard or seen very angry disagreements or violence at home or on changeover?*
  • In the past 6 months, did any of your children strongly resist seeing either parent?*
  • Please select any words that describe how you feel these days about being separated/divorced from the other parent?*
  • Which of the following tools or methods of communication are consistently used to manage your co-parenting communication?

  • Additional information

  • Should be Empty: