Children & Finances Family Mediation
Please complete as fully as possible, e.g. working hours, flexibility, etc.
Legally aided. Yes or No
Liable to pay fees. Yes, No or Not sure
Is it Legally aided. Yes or No?
Please give details, including court and hearing date.
Is there a history of domestic violence? Yes or No
Is there a history of child protection issues? Yes or No
Please tick main issues.
Pre-separation issuesChild arrangementsPost-divorce problemsReaction to divorce/separationFinance and propertyOther
Is other party aware of referral? Yes or No