Essay on Mediation Intake Form

Words: 1107
Pages: 5

Pre-Mediation Information Gathering and Client Intake

Unit 3 Assignment: Pre-Mediation Information Gathering and Client Intake
Latanisha Sawyer
Kaplan University
PA415: Family Law and Divorce Mediation
Prof: Ally Howell

Pre-mediation Questions: 1. What mutual concerns do David and Angela have? What are their individual concerns?

A mutual concern of David and Angela is that they both have lost ambition and this in turn has placed a strain on their marriage. Angela feels as though David has become increasingly distant in their relationship and has accused David of committing adultery. David at the beginning of the relationship was outgoing, but that has since changed placing strain on the relationship. David
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Most importantly David and Angela will need to understand how divorcing will affect the children. Both parents need to be able to communicate in a healthy manner for the children and understand that although they are divorcing they still have to have a relationship with one another that will allow them to co-parent their children without harming them through the effects of divorce.

Mediation Intake Form Client Information
Full Legal Name: (Maiden Name):
Client Mailing Address: Social Security #:
Telephone Home: ( ) Cell ( )
Work: ( ) E-mail:
Date of birth: Current Age:
College Degree/Certificates: Major/Year
H.S. Diploma:
Attorney Information:
Attorney Name: Attorney Firm:
Attorney Address: Contact Number:
E-mail Address: Fax Number:
Have you already begun legal proceedings? If so, when?
If applicable, case number: Children (list full names) | Birth Date: | Age: | Living with: | | | | | | | | | | | | | | | | | | | | |
Children of this Relationship History of Marriage:
Date of Marriage: Number of Years Married: Date of separation: Place of Marriage: Ceremony Type If applicable, date of separation: Living together now? Is your spouse employed? Length of Employment: