Family Court Services Tier 1 Intake Form {PFC-15}

Orientation : Completion of the Online FCS Orientation is ordered by the Court and is essential to your success in the Mediation session . The Orientation will prov ide essential information about your upcoming mediation appointment. You can view the complete FCS audio and visual slide show Orientation Online at www.fresno.courts.ca.gov/family/familycourtservices.php The same online slide show will be show n in the FCS lobby every Friday at 1:0 0pm in English and 2:30pm in Spanish Please read this ENTIRE packet very carefully. T his p acket must be complet ed P RIOR to Your Mediation Appointment The mediator will use this FCS Intake Form to familiarize themselves with your family and to be better prepared to meet your needs during the mediation session. The FCS Intake Form will NOT be shared with the Judicial Officer or the other parties on the case. Purpose of Mediation : The Family Court Services Mediator can help parties formulate a parenting plan reg arding the following issues: How the children will spend time with each party (regular time and holidays) How the parties will make legal decisions about the children How the children will be transported and exchanged for the visits Participation in progra ms or services that may be beneficial for the family Safety Considerations Although parents are expected to actively participate in the mediation process, parents are in NO WAY obligated to agree to a parenting plan Financial considerations including division of property, child support and spousal support are not addressed in Family Court Services Mediation. SUPERIOR COURT OF CALIFORNIA COUNTY OF FRESNO FAMILY COURT SERVICES Fresno, CA 93721 (559)457 - 2100 (option #4) FresnoFCS@fresno.courts.ca.gov Family Court Services Tier 1 Intake Form Page American LegalNet, Inc. www.FormsWorkFlow.com Family Court Services Tier 1 Intake Form Page2 Confidentiality : Pursuant to Family Code 247 3188, Mediation is private and confidential. The mediator may not make a recommendation as to custody or visitation to anyone other than the parties participating in the mediation appointment to the Court, the mediator will not disclose what occurred in mediation with the following exceptions: If the Mediator d etermines there is reasonable suspicion of danger to one of the parties or others, the mediator is required to report suspected child abuse, elder abuse, and/or if someone is a danger to themselves or others to the appropriate agency. In the event of a par tial agreement the Mediator will report the partial agreement to the Court. In addition, a list, in neutral terms, of the unresolved issues may be provided to the Court with consent from all parties. Documents: The Family Court Services Mediator has access to documents filed with the Court. The Mediator may discuss documents provided by the parents during the mediation session, for the sole purpose of facilitating an agreement between the parties regarding custody and visitation. The Mediator will N OT retain any documents presented by the parties during the Tier I mediation. Interpreters: If you do not speak English, you must bring your own interpreter to your mediation appointment . Failure to bring your own interpreter may result in cancellation o f your Mediation appointment. Si usted no habla Ingl351s, usted debe traer su propio int351rprete. La falta de traer su propio int351rprete puede resultar en la cancelaci363n de su Mediaci363n de custodia de los hijos. Separate Sessions : Pursuant to Family Code 2473181 , where there has been a history of domestic violence between the parties or where a protective order as defined in 2476218 is in effect, at the request of the party alleging domestic violence in a written declaration under penalty of perjury or protect ed by the order, the Mediator appointed pursuant to this chapter shall meet with the parties separately and at separate times. If you feel that separate sessions are appropriate due to a history of domestic violence, please contact Family Court Services te be submitted to Family Court Services at least five days prior to your Mediation appointment. American LegalNet, Inc. www.FormsWorkFlow.com Family Court Services Tier 1 Intake Form Page 3 Common Terms : Sole Legal Custody on e parent has the right and responsibility to make decisions related to the health, education and welfare of the child. Sole Physical Custody a child shall reside with and be under the supervision of one parent, subject to the Court ordering visitation for the other paren t . Sole physical custody is ordered in cases when one parent has limited contact with the children, typically less than 33%. Joint Legal Custody both parents share the right and responsibility to make decisions related to the health, e ducation and welfare of the child . Joint Physical Custody each parent has significant periods of time with the child. Joint physical custody shall be shared in such a way as to assure a child of frequent and continuing contact with both parents. Howe ver, joint physical custody does not always mean equal time with both parents. For additional information: www.fresno.courts.ca.gov/family/familycourtservices.php email: FresnoFCS@fresno.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com Page SUPERIOR COURT OF CALIFORNIA COUNTY OF FRESNO (Fi rst) (Middle) (Last) ( Nickname, Aliases, Maiden Name) (Number and Street Name) (Apartment No.) ( ) ( ) (Home) (Work / Cell ) (First) (Middle) (Last) (If Unemployed, Please Write 223Unemployed224): : MON TUES WED THURS FRI SAT SUN Name DOB School Name DOB School Name DOB Relationship Name DOB Relationship YES NOxpiration date: under penalty of perjury YES NO YES NO YES NO NO YES NO YES YES NO YES NO If you answered 221YES222 to questions #2 and #4, please immediately contact Family Court services by calling (559) 457-2100 and selecting option #4 to receive a packet regarding your request for separate mediation sessions. FAMILY COURT SERVICES TIER 1 INTAKE FORM Case Number: American LegalNet, Inc. www.FormsWorkFlow.com Page 5 YES NO Sole Legal Sole Physical Joint Legal Joint Physical Easter: Thanksgiving: Christmas: Sole Legal Sole Physical Joint Legal Joint Physical Easter: Thanksgiving: Christmas: (Date) (Signature) American LegalNet, Inc. www.FormsWorkFlow.com