Off the Record. On Your Side. When no one else gets it, we do. The system won’t save you – We help you save yourself.

This form gives us a starting point. You don’t need to share every detail here—just enough to help us understand the big picture.

We’ll go deeper into your story, evidence, and goals during your coaching session, where we can talk more openly and strategically one-on-one.

Name

Email Address

Phone Number

Preferred Method of Contact: Preferred Method of Contact: Text Phone Email

Number of Children

City

State

County

Current Legal Custody Arrangement Current Legal Custody Arrangement No order yet Temporary order Final order Informal Agreement

Judge

Case Number

Is the current order being followed?

Do you currently have an attorney?

Do you have an upcoming court date? When?

What are you most in need of right now? (Check all that apply) What are you most in need of right now? (Check all that apply) Exit Planning Safety Prep Evidence Organization Custody Communication Strategy Strategic Court Prep Contempt/Enforcement Planning Formatting/Structuring Declarations Emotional Support Other

How would you describe your co-parenting relationship? How would you describe your co-parenting relationship? Cooperative Tense but functional High-conflict Abusive or dangerous

What are you most afraid of in this process?

What would success look like for you?

Anything else you want us to know? We will go over details of your case during the coaching call.

Disclaimer Disclaimer Off The Record Child Custody is a strategic coaching service. We do not provide legal advice, legal representation, or document preparation. Our coaching is based on experience, research, and communication strategies. Submitting this form does not create an attorney-client relationship. By submitting this form: You affirm that the information provided is truthful to the best of your knowledge. You understand that all coaching is confidential, but not protected by attorney-client privilege. You agree not to reproduce, sell, coach from, or distribute any content, strategy, or materials provided to you. You understand that all services are offered in good faith, and you accept full responsibility for how you choose to use the support provided. You acknowledge that Off The Record Child Custody makes no guarantees regarding any legal outcomes or court rulings. How you use the information and support provided is entirely up to you, and you agree that Off The Record Child Custody is not liable for the results of your custody case or any legal proceedings. By checking this box and submitting your intake form, you acknowledge that you have read, understood, and agreed to the above terms and disclaimer.

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