Family Court Help Request Form

Family Court Help Request Form
Our Kinship Care unit provides free legal representation to caregivers of all ages in Erie and Niagara counties.

Our clients are often seeking temporary or permanent custody of children (nieces, nephews, siblings, grandchildren) because the parents are unable to continue parenting.

Services provided include: representation in neglect and abuse, custody, guardianship, adoption, child support, family offense, and administrative matters.

Your Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Last Four Digits of Social Security Number
The information in this form is not shared, and is encrypted for your protection.
Primary Phone Number
Best Phone Number to Reach YouFormat: (000) 000-0000.
Secondary Phone Number
Secondary Number if AvailableFormat: (000) 000-0000.
Email
example@example.com
Your Date of Birth

MonthDayYear

We are required to collect some information for conflict checks.
Marital Status
Your Spouse's Name

First NameLast Name
Are you aware of any other party/person seeking custody of the child/children? If yes, what are their names, ages, and relationships to you?
Please list every individual or party seeking custody:
How did you hear about the Center for Elder Law & Justice, or, who referred (sent) you?
Please list every individual who resides/lives in your home:
Total Household Income ($)
Income Received:
Total Yearly Household Income
Total Yearly Household Income Calc Field
Please list every individual who resides/lives in your home and earns income:

What is your relationship to the child/children involved with the court matter? If you are not biologically related to the child/children, how do you know the child/children?
Where, and with who, are the children residing with currently? How long have they been there and why? Are the children with you, staying in a non-relative foster home, or somewhere else? Please provide details.
Has Child Protective Services (CPS) been involved with the child/children?
Has CPS removed the child/children? If yes, when and why?

Unfortunately, we cannot assist with visitation matters.