top of page

Home
About
Services
Online Courses
- 7 Principles Workshop
Blog
Recommendations
Contact
More

Use tab to navigate through the menu items.

Intake

Intake Form

Get in touch so we can start working together.

First Name

Email

Last Name

Phone

Address

Attorney's name

Attorney's Email

Attorney's Phone

Other Party's Name

Other Party's Email

Other Party's Phone

Address

Married?

Yes

No

If yes, how long?

Separated?

Yes

No

If yes, how long?

If Yes, What are their names and ages?

Do you share children?

Yes

No

Case Type

Divorce

Parentage

Modification

Motion to Enforce

Marraige Mediation

Restorative Family Circles

Is there a Guardian Ad Litem?

Yes

No

Is there a Protective Order? *

Yes

No

Has the case been filed in court?

Yes

No

Case Number

If Yes, Who is the Petitioner? (The person filing)

If Yes, Who is the Respondent?

Who is the Judge?

Who is the Commisioner?

If Yes, What is their name?

If Yes, Please attach a copy.

Upload File

Upload supported file (Max 15MB)

What are the Main Issues you'd like to discuss in Mediation?

Thanks for submitting!

utcmediation@gmail.com

bottom of page