Application for Intensive Relationship Intervention
Submit this form to have your case evaluated for whether or not your situation is a good fit for our unique approach for resolving disputes.
Your Case Evaluation is free.
You will receive an invitation for a 1-on-1 meeting if your case is a good fit. The fee for the call will be $350 for 1 hour.
Name
*
First Name
Last Name
Email
*
example@example.com
Telephone Number
*
Your Age
*
Information About the Defendant in Your Case
The Defendant is the person you have a complaint against. This could be your spouse, child, parent or other family member. This is for our information only and we will not contact your family member without your permission.
Name
*
First Name
Last Name
Defendant's Email
*
example@example.com
Defendant's Telephone Number
Defendant's Age
*
Information About Your Relationship
Please provide basic information abut your relationship with the Defendant.
What is your relationship to the Defendant?
What is your position regarding separation/divorce?
*
I'm trying to figure out if we should separate
I'm trying to figure out if we should divorce
I'm committed to our marriage, even though things get really tough some times
I am not married to the Defendant
Have you and the Defendant been involved in any court proceedings, such as separation, divorce, child custody, guardianship, or any criminal matter?
*
No
Yes
Have you or the Defendant ever initiated any calls to the police to resolve your differences?
*
No
Yes
Have you ever been physically violent towards the Defendant?
*
No
Yes
Has the Defendant ever been physically violent towards you?
*
No
Yes
Information About Your Dispute
Provide a summary of the most recent disagreement between you and the Defendant.
When did the disagreement begin (estimate a date or period of time)
*
What was the Defendant's behavior that gave rise to your dispute?
*
How did you respond to the Defendant's behavior?
*
Based on your understanding and what has happened, what unmet needs does the Defendant have?
*
What would be an outcome that would make this right for you?
*
I understand that Law for Love/Judge Char does not hear cases for divorce.
*
I understand and am not seeking help with a divorce.
I understand that if my case is accepted, there is a $350 Case Evaluation Fee for a follow-up 1-on-1 with Law for Love/Judge Char
*
I understand that if my case progresses, I am responsible for a Case Evaluation fee at the time my 1-on-1 meeting is scheduled.
Submit
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