Family Intake

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Type of Family Law issue: Domestic violenceChild custody & visitationChild supportDivorce

DOMESTIC VIOLENCE

A. Safety Planning

1. Are you living with the abuser and/or in immediate danger? YesNo
if yes,

If you are in immediate danger, please call 911 and consider developing a safety plan:
If you do not think you are in immediate danger but are still living with the abuser, please consider developing a safety plan:

B. Status of Case

1. Do you have a Civil Protection Order (CPO) case at court? YesNo
if yes,

a. Is there a court date set? YesNo
if yes,

i. When is the next court date?
ii. What is the Courtroom number?
iii. What is the Case number?
iv. When was the case filed?
v. Have any continuances been granted previously?
vi. Is opposing party represented by counsel? Please list any information regarding opposing counsel.

b. Who filed for the Civil Protection Order (CPO)? MeOther Party
if other party,

i. Do you admit or deny the allegations listed in the petition?
ii. What is your side of the story?

i. What would you like the court to do in your case?

ii. If you want the other party to leave the home, who is
on the lease/mortgage to the home?
iii. If you want the other party to reimburse you for damages, do you
have proof/evidence of the damages? What was damaged? What
was the cost?

c. Were there any witnesses present during any of the domestic violence incidents? YesNo
if yes,

If so, what are their names and phone numbers, if you have them?
[/group witnessdv]
2. Are there any other current cases involving you and the other party?
3. Have there been any prior cases of any kind between the two of you? (past CPOs,
custody / visitation, child support, divorce, etc.)
4. Do you and the other party have any children together? YesNo

What are their names and dates of birth or ages?

Where have the children been living and how long have they lived
there?

5. Will child custody/visitation also be an issue between you and the other party? YesNo
if yes,

CHILD CUSTODY AND VISITATION

NOTE: If you are not the parent (biological or adoptive) to the children at issue in this case, then please do not proceed with this online application. Please call our Intake Unit at 202.628.1161 for more information.

Case Status
1. Do you have a custody/visitation case in DC Court? YesNo

When is the next court date?
Who filed the case?
What do you want to happen? Why?
What does the other party want? Why?
Is this a Motion to Modify an existing custody order?

2. What are the names and dates of birth for all of the children in the case?

3. Where do they live now?

4. What is the current custody arrangement -- and is it formal or informal?

5. How long has the current arrangement been going on?

6. Have there been any other types of cases of any kind between you and the other party? (e.g., domestic violence, custody/visitation, child support, divorce, etc.)

7. Are you asking for child support in the same case as custody? YesNo

if yes,

I. Background Info
A. Names and dates of birth of all children for whom support is sought.

B. Do all children live primarily with you or the other party – or is their time split equally between both of you?
C. Do you or the other party receive TANF or SSI/SSDI?
D. Has one of the parties or CSSD (the Child Support Services Division of the Office of the Attorney General) started a case? Who started the case?

E. Are there any other current or prior cases involving the same parties and child(ren) (e.g., CPO, custody/visitation, divorce)?

II. Paternity
A. Do you or the other party have questions about biological paternity? Why?

B. Is the father on the birth certificate? Is there a DNA test? Were the parties married?

III. Child Support Questions
Do you want to: Start a child support caseIncrease child support orderTry to enforce an existing child support orderLower/Stop existing child support order

If person checks off start a child support case or increase an order
1. Is there currently a child support order? YesNo
if yes,

a. Is the case in DC? YesNo

Please stop here and call our Intake Unit at 202.628.1161 for a possible referral.
b. When was it put in place?
c. Has anything changed since the current order was issued?
d. Is it more than 3 years old?
2. Is the other parent working? YesNoI don't know

a. Where?
b. How long?
c. How much do they make?
3. Have you filed in court a Petition for Child Support or Motion to Modify an Existing Order?

1. Is the case in DC? YesNo
If no

Please stop here and call our Intake Unit at 202.628.1161 for a possible referral.

if yes,

2. How much is the current order?
3. Has a Motion for Contempt already been filed? YesNo
4. How much does the other parent owe in child support (in total)?

1. Is the case in DC? YesNo

Please stop here and call our Intake Unit at 202.628.1161 for a possible referral.
1. What is the current order for?
2. When was it put in place?
3. What has changed since the order was put in place that makes it hard/impossible to pay the order?
4. Is order more than 12 years old?
5. Has a Motion to Modify already been filed?

IMPORTANT DOCUMENTS IN CHILD SUPPORT CASES
If you have any of the following documents, please upload them here, e-mail (to onlineintake@legalaiddc.org) or fax them to 202.727.2132 (Attn: Online Intake)

A. Any and all court papers regarding child support for the child(ren) at issue
B. Acknowledgement(s) of paternity or birth certificate(s) for child(ren) at issue
C. Proof of expenses for health insurance, childcare, and extraordinary expenses
D. Agreements between parties
E. Correspondence between parties
F. Social media of either party showing living expenses or income

8. Are you asking for a divorce in the same case as custody? YesNo

Background Info
1. What are the names of all the other adults and children living with the children in this case?
2. Do the children live in DC? YesNo
If no

How long have they been away from DC?

if yes,

3. How long have they lived at their current home?

4. Do the children have any special needs?
5. Is there any question about paternity of the children in the case?
If yes,

If so, why?

6. Is there a history of domestic violence / CPOs between you and the other parent? YesNo
If yes

Please describe the domestic violence.

7. What is the criminal history of you and the other parent?
8. What is the drug or alcohol abuse history for you and the other parent?
What, if any, treatment?
9. What is the mental health history for you and the other parent?
What, if any, treatment?
10. Have there ever been allegations of abuse or neglect against you and/or the other parent?
11. Did something happen recently that caused the custody case to start?

12. If this case is a Motion to Modify, when was the last custody order put in place?
What did that order say?
What happened to cause the new case?

IMPORTANT DOCUMENTS IN CUSTODY/VISITATION CASES
If you have any of the following documents, please upload them here, e-mail (to XXX@legalaiddc.org) or fax them to 202.727.2132 (Attn: Online Intake)

A. Any and all family court papers related to you, other party and your children
a. This includes home studies, psychological evaluations, etc.
B. Any and all criminal court papers related to you and/or the other party
C. Any written correspondence between you and the other party
D. Social media messages by either party about the child or showing parenting concerns
E. Any school, medical or other records you think are relevant

C. Temporary Protection Order (TPO)
1. Has a Temporary Protection Order (TPO) been granted? YesNo
if yes,

To whom?
2. What relief was granted in the TPO?
3. When does the TPO expire?
4. Has TPO already been extended in the past?

E. History of Domestic Violence
Domestic Violence in this context is a crime or attempted criminal act under DC law committed by an intimate partner, family member, or roommate against you. These are things like assault, stalking, property destruction, and threats to do harm to another person.
We consider domestic violence to include:
• physical abuse;
• emotional abuse;
• psychological abuse;
• use of isolation;
• use of economic control;
• deprivation of medical care; and
• any other exercise of power and/or control in the parties’ relationship.

1. Please list all incidents of domestic violence starting with the most recent incident. Include dates of the incidents.
2. In each of the above incidents, please indicate if you were the perpetrator, i.e. started the incident, and/or if you acted in self-defense.
3. Did anyone require medical or hospital treatment as a result of any domestic violence incidents? YesNo
If yes

a. When and where?
b. What were the injuries?

4. Were there any witnesses to any of the above incidents? YesNo
If yes

What did the witness see?

5. If you have children, were any present during any domestic violence incidents? YesNo
if yes,

What was their reaction?

6. Were weapons or any other objects used in the course of any domestic violence incidents? YesNo
If yes

a. What was the weapon/object?
b. How was it used?
c. How many times did this occur?

7. Was anyone under the influence of drugs or alcohol during any incidents of domestic violence? YesNo
If yes

a. What was the drug used?
b. How often is that drug consumed?

8. Has 911 ever been called? YesNo
If yes

a. When and where?
b. Who called them?

9. Have the police ever been involved in any of the domestic violence incidents? YesNo

If yes,

a. When and where?
b. Was a police report taken afterwards? YesNo
If yes
i. When and where?
ii. If you have it, what is the name and information of the reporting officer?
c. Was anyone arrested as a result of the domestic violence? YesNo
If yes

i. When and where?
ii. Who was arrested?

10. Has there ever been a criminal case papered? YesNo
If yes

a. When and where?
b. Against whom?
c. Was there a conviction?

IMPORTANT DOCUMENTS IN DOMESTIC VIOLENCE CASES
If you have any of the following documents, please upload here, e-mail (to XXX@legalaiddc.org) or fax them to 202.727.2132 (Attn: Online Intake)

A. Any and all family court papers related to you, other party and your children
B. Any and all criminal court papers related to you and/or the other party
C. Any evidence of domestic violence, including but limited to:
1. Text/voice messages
2. Emails
3. Social media messages
4. Pictures of injuries or damage to property
5. Hospital records
6. Police reports (or police report information)

CHILD CUSTODY AND VISITATION

NOTE: If you are not the parent (biological or adoptive) to the children at issue in this case, then please do not proceed with this online application. Please call our Intake Unit at 202.628.1161 for more information.

Case Status
1. Do you have a custody/visitation case in DC Court? YesNo
If yes

a. When is the next court date?
b. Who filed the case?
c. What do you want to happen? Why?
d. What does the other party want? Why?

Is this a Motion to Modify an existing custody order? YesNo
If yes,

2. What are the names and dates of birth for all of the children in the case?
3. Where do they live now?
4. What is the current custody arrangement -- and is it formal or informal?
5. How long has the current arrangement been going on?
6. Have there been any other types of cases of any kind between you and the other party? (e.g., domestic violence, custody/visitation, child support, divorce, etc.)
7. Are you asking for child support or a divorce in the same case as custody?

Background Info
1. What are the names of all the other adults and children living with the children in this case?
2. Do the children live in DC? YesNo
If no

How long have they been away from DC?

if yes,

3. How long have they lived at their current home?

4. Do the children have any special needs?
5. Is there any question about paternity of the children in the case? If so, why?
6. Is there a history of domestic violence / CPOs between you and the other parent? YesNo
If yes

Please describe the domestic violence.

7. What is the criminal history of you and the other parent?
8. What is the drug or alcohol abuse history for you and the other parent? What, if any, treatment?
9. What is the mental health history for you and the other parent? What, if any, treatment?
10. Have there ever been allegations of abuse or neglect against you and/or the other parent?
11. Did something happen recently that caused the custody case to start?

12. If this case is a Motion to Modify, when was the last custody order put in place? What did that order say? What happened to cause the new case?

IMPORTANT DOCUMENTS IN CUSTODY/VISITATION CASES
If you have any of the following documents, please upload them here, e-mail (to XXX@legalaiddc.org) or fax them to 202.727.2132 (Attn: Online Intake)

A. Any and all family court papers related to you, other party and your children
a. This includes home studies, psychological evaluations, etc.
B. Any and all criminal court papers related to you and/or the other party
C. Any written correspondence between you and the other party
D. Social media messages by either party about the child or showing parenting concerns
E. Any school, medical or other records you think are relevant

CHILD SUPPORT

I. Background Info
A. Names and dates of birth of all children for whom support is sought.
B. Do all children live primarily with you or the other party – or is their time split equally between both of you?
C. Do you or the other party receive TANF or SSI/SSDI?
D. Has one of the parties or CSSD (the Child Support Services Division of the Office of the Attorney General) started a case? Who started the case?
E. Are there any other current or prior cases involving the same parties and child(ren) (e.g., CPO, custody/visitation, divorce)?

II. Paternity
A. Do you or the other party have questions about biological paternity? Why?
B. Is the father on the birth certificate? Is there a DNA test? Were the parties married?

III. Child Support Questions
Do you want to:
Start a child support caseIncrease child support orderTry to enforce an existing child support orderLower/Stop existing child support order

If person checks off start a child support case or increase an order,

1. Is there currently a child support order? YesNo
If yes

a. Is the case in DC? YesNo
If no

Please stop here and call our Intake Unit at 202.628.1161 for a possible referral.

if yes,

b. When was it put in place?
c. Has anything changed since the current order was issued?
d. Is it more than 3 years old?

2. Is the other parent working? YesNo

a. Where?
b. How long?
c. How much do they make?

3. Have you filed in court a Petition for Child Support or Motion to Modify an Existing Order?

If person checks off “try to enforce an existing order”

1. Is the case in DC? YesNo
If no

Please stop here and call our Intake Unit at 202.628.1161 for a possible referral.
2. How much is the current order?
3. Has a Motion for Contempt already been filed?
4. How much does the other parent owe in child support (in total)?

If person checks off “lower/stop an existing order”

1. Is the case in DC? YesNo
If no

Please stop here and call our Intake Unit at 202.628.1161 for a possible referral.
1. What is the current order for?
2. When was it put in place?
3. What has changed since the order was put in place that makes it hard/impossible to pay the order?
4. Is order more than 12 years old?
5. Has a Motion to Modify already been filed?

IMPORTANT DOCUMENTS IN CHILD SUPPORT CASES
If you have any of the following documents, please upload them here, e-mail (to XXX@legalaiddc.org) or fax them to 202.727.2132 (Attn: Online Intake)

A. Any and all court papers regarding child support for the child(ren) at issue
B. Acknowledgement(s) of paternity or birth certificate(s) for child(ren) at issue
C. Proof of expenses for health insurance, childcare, and extraordinary expenses
D. Agreements between parties
E. Correspondence between parties
F. Social media of either party showing living expenses or income

DIVORCE

Marriage Info
A. Date and place of marriage
B. Where do you and the other party live now?
C. When did you and the other party separate?
D. Is there any history of domestic violence between the two of you? YesNo

Please explain.

Divorce Info
A. Have you or the other party filed for divorce? If so, has there been service?
B. Why do you want to get divorced? What happened?
1. Do you both have minor children together? YesNo
If yes,

What are their names and ages?
Do they want the court to decide custody and/or child support?

E. Do you and the other party have marital property (e.g. house, car, bank accounts, retirement or pension funds, debts—credit cards, mortgage)? YesNo
If yes,

F. What marital property would you want the court to distribute?

G. Are you or the other party asking for alimony?
H. What is your income and the income of the other party?