Court in which your case is managed (i.e. 19th JDC, etc.)
All doctors the parent has seen in the last 10 years
All doctors each child has seen in the last 10 years
All counselors each parent has seen
All counselors each child has seen
Each child’s school and/or daycare
Anyone else Dr. Belaire needs to interview
Separate consent forms are needed for each family member for each professional (i.e. mother’s attorney, mother’s doctor, father’s attorney, father’s doctor, child 1’s doctor, child 1’s school, child 2’s doctor, child 2’s school, etc.). Do not combine multiple family members on one form. Do not include more than one third party individual/organization on one form. You will need to print multiple copies of this form.