Divorce Mediator

 Custody Mediation Los Angeles, Family Law Mediation
Divorce Mediation Services, Custody Mediation Los Angeles
Divorce Mediation Services, Custody Mediation Los Angeles
Divorce Mediation Services, Custody Mediation Los Angeles
 
Mediation Services
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
 
 
Divorce Mediation Services, Custody Mediation Los Angeles
Divorce Mediation Services, Custody Mediation Los Angeles
Divorce Mediation Services, Custody Mediation Los Angeles
Divorce Mediation Services, Custody Mediation Los Angeles

“Patty DeDominic is always happy to encourage people and organizations to utilize mediation services and believes that Peace Talks mediators are taking this important skill and protocol to greater visibility. Peace Talks mediators live their mission and they encourage others to find ways to make peace in business and in life. I wish we could employ her immediately to stop almost all litigation in the USA!”



Patty Dedominic, Owner, DeDominic & Associates


Divorce Mediation Services, Custody Mediation Los Angeles

 

 

 

 

 
Divorce Mediation Services, Custody Mediation Los Angeles
Divorce Mediation Services, Custody Mediation Los Angeles
  PERSONAL DATA AND INFORMATION
  1. Name  
  Home Address
   
Street   City
   
 Zip
Work Phone  Home Phone
   
Best way to contact you:   E-mail
 
  2. Age      
  3. Date of Marriage 5 October 2009 Date of Separation  
  4. Children of Current Marriage      
      Full Name Date of Birth Residing With  
    Child1  
    Child2  
    Child3  
     
Are you currently paying support for these children? Yes No
 
  5. Children of Previous Marriage/Relationship?  
      Full Name Date of Birth Residing With  
    Child1  
    Child2  
    Child3  
     
Are you currently paying support for these children? Yes No
 
  6. Other than your children and/or your spouse, are there any people living with you  
   
now?   Yes No  
 
    If yes, list their names and their relationship to you    
   
Name   Relationship
 
  7.
Are you employed? Yes No  
 
    If yes, give name of employer:      
   
Address of employer
 
Street City             State                 Zip  
 
 
    Job Title Nature of Job  
    Date Hired Current Salary  
  8.
Highest level of education attained  
 
   
Field(s) of study  
 
  9.
Do you have an interest in reconciliation?  Yes No
 
   
As far as you know, does your spouse? Yes No
 
  10.
Are you presently seeing a counselor or therapist?    Yes No
 
   
If yes,   Individual Joint Family
 
   
Please list name of counselor or therapist  
 
  11.
Have you previously seen a counselor or therapist?  Yes No
 
   
If yes,   Individual Joint Family
 
  12.
Do you anticipate a dispute about custody of the children? Yes No
 
  13.
Do you presently have an attorney?  Yes No
 
   
  Name           Address         Phone      
 
  14.
Yes No
 
  15.
Does your spouse have credit cards you are responsible for? Yes No
 
  16.
Do you have a will?  Yes No
 
 
17. How did you learn about Diana Mercer and Peace Talks Mediation Services?
 

(Give name and relationship, where applicable)

    
 
     
 
18. Security Code Divorce Mediation Services, Custody Mediation Los Angeles
   
 
 




 
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