Family Assessment Form 2025

1
A booking will only be accepted if the following is provided:

✔ Copy of the relevant Orders and/or joint letter confirming agreement of the parties to attend the assessment

✔ Complete contact details for the parties’ and their legal representatives (please do not leave this information blank)

✔ Confirmation in writing that funds are readily available to pay the Expert's fee for the assessment and report
2
Name of matter and court reference* This field is required.
3
Are you seeking* This field is required.
Single Expert Report
Child Impact Report / Short Form Report
Mental Health Assessment of Parent only
Other
4
If “Other,” please specify:
5
Have there been / are there allegations of violence, threats, or firearm offences? Including domestic violence and / or coercive controlling violence?* This field is required.
YESNO
6
Have there been / are there allegations of drug and alcohol abuse?* This field is required.
YESNO
7
Have there been previous complaint proceedings against professionals involved in the case to date? E.g., child protection services, lawyers, health professionals etc.* This field is required.
YESNO
8
Have there been / are there allegations of child sexual abuse?* This field is required.
YESNO
9
How many children are to be interviewed* This field is required.
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Large
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Small
Ok
Ok
10
Please provide their full name and age (for multiple children, please list all names and age separated by a comma).E.g. John Doe 5, Jane Smith 6
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Ok
11
Are there any additional people to be assessed including extended family members* This field is required.
YESNO
12
If yes, please provide their name and what their relationship to the child/children is (Please note that it is at the discretion of the Single Expert whether these people will be interviewed)* This field is required.
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Ok
13
Please advise what days of the week the child/children are typically with each parent.E.g. Monday, Wednesday, Friday = Mum. Tuesday, Saturday & Sunday = Dad
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Ok
14
Are their funds in trust/readily available to pay for this report? * This field is required.
YESNO
15
Please confirm how you would like our fees to be invoiced
split equally between the parties
the applicant is responsible for the whole amount
the respondent is responsible for the whole amount
16
Number of pages included in reading material* This field is required.
< 500 pages
> 500 pages
> 1000 pages
17
Are there any further details you wish to include?* This field is required.
18
Full Name* This field is required.
19
Date of Birth * This field is required.
Date
Year
Month
Day
20
Mobile Number* This field is required.
Country Code
Area Code
Phone Number
21
Email Address* This field is required.
example@example.com
22
Full Name* This field is required.
23
Firm Name * This field is required.
24
Contact Number * This field is required.
Area Code
Phone Number
25
Email Address* This field is required.
example@example.com
26
Full Name* This field is required.
27
Date of Birth* This field is required.
Date
Year
Month
Day
28
Mobile Number* This field is required.
Area Code
Phone Number
29
Email Address* This field is required.
example@example.com
30
Full Name* This field is required.
31
Firm Name* This field is required.
32
Contact Number* This field is required.
Area Code
Phone Number
33
Email Address* This field is required.
example@example.com
34
Full Name
35
Firm Name
36
Contact Number
Area Code
Phone Number
37
Email Address
example@example.com
Should be Empty: