Family Law Child Custody And Visitation Questionnaire {FL045}

Attorney or Party Without An Attorney (Name, Address, Telephone Number) Attorney for (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SONOMA Civil and Family Law Courthouse Family Law Division 3055 Cleveland Avenue Santa Rosa, Ca 95403 Telephone: (707) 521-6500 Petitioner/Plaintiff: Respondent/Defendant: Other Parent/Claimant: Hearing Date: Dept. Number: FAMILY LAW CHILD CUSTODY/VISITATION QUESTIONNAIRE Please provide the following information and complete this document in its entirety. Only use the boxes provided to answer the questions. In the past 90 days, how many times have you spoken with your child(ren)? In the past 90 days, how many times have you visited with your child(ren)? List the date you last visited with your child(ren)? ____________ Have you asked to visit with your child(ren) and the other parent said, "No"? ____________ ____________ Yes Yes Yes Yes Yes Yes No No No No No No Do you believe your child(ren) should decide when they will visit the other parent? Do both parents have access to the child(ren)'s medical and/or school records? Has/Have your child(ren) told you that he/she or they do not want to see you? Has your child(ren) told you they do not want to see the other parent? Do you believe the child(ren) are not safe with the other parent? Instructions: This form is for optional use. If you elect to complete this form it must be filed with the court and served to the other party. American LegalNet, Inc. www.FormsWorkFlow.com FL-045 Adopted for Optional Use Eff. 1/1/18 FAMILY LAW CHILD CUSTODY/VISITATION QUESTIONNAIRE Page 1 of 1