Forms and Fees
- Sample Order for Child Custody Evaluation
- CCE Instruction Letter
- CCE Advisement Form
- CCE Personal History Questionnaire
- CCE Parenting Reference Form
- Acknowledgement of Notice of Privacy Practices
- Evaluation Fee Schedule
- Sample Order for Adoption Evaluation
- Adoption Evaluation Instruction Letter
- Adoption Evaluation Advisement Form
- Adoption Evaluation Personal History Questionnaire
- Adoption Personal Reference Form
- Acknowledgement of Notice of Privacy Practices
- Evaluation Fee Schedule Other forms required by the State of Texas for adoptions (send directly to the related agencies; see instruction letter):
- CPS 2970 Registry Check
- DPS Fingerprint Check
- Checklist for Initiating Supervised Visitation <--START HERE
- Supervised Visitation Data Form
- Supervised Visitation Guidelines
- Acknowledgement of Notice of Privacy Practices
- Designated Alternate Form (used only when someone besides the custodial parent is transporting)
- Cost Multipliers for Personal Supervision by the Program Director (used only when Dr. Robb is requested to personally supervise)
- Supervised Visitation Fee Schedule
- Sample Order for Supervised Visitation Other forms related to supervised visitation:
- Supervised Visitation Quick Reference Page
- Information on choosing visit locations
- Pamphlet on Preparing Children for Visits
- Information on visitation records and our involvement in court
- Guidelines for non-professional supervisors
- Online training for non-professional supervisors
- Neutrality in Services
We accept a limited number of parenting facilitation cases. Please have your attorney contact us prior to naming us in an order to insure that we are available.
- Sample Order for Parenting Facilitation
- Parenting Facilitation Introduction Letter
- Parenting Facilitation Data Form
- Parenting Facilitation Advisement Form
- Acknowledgement of Notice of Privacy Practices
- Parenting Facilitation Fee Schedule Other forms related to parenting facilitation:
- Parenting Facilitation Quick Reference Page
- Parenting Facilitation Decision Making and Trigger Language Examples
Instructions for beginning court-connected therapy:
Please complete only one copy per adult:- Adult Data Form
- Therapy Advisement Form
- Court-Connected Services Addendum
- Acknowledgement of Notice of Privacy Practices
- Good Faith Estimate for Health Care Items and Services
- Adult Information Form
- Consent for Treatment of a Minor (one copy from each parent/legal conservator, can include all children on one form)
- Good Faith Estimate for Health Care Items and Services (one *per child* from each parent/legal conservator)
- Child Information Form (one *per child* from each parent/legal conservator) Other forms related to therapy services:
- Therapy Fee Schedule
- Sample Therapy Orders (from CoParentingTexas.com)
- Therapists and Custody Recommendations (from North Texas FIT)
Guardian Ad Litem Appointments
- Sample GAL Order
- GAL Instruction Letter
- GAL Advisement Form
- GAL Data Form
- Acknowledgement of Notice of Privacy Practices
Other Services
Please contact us directly regarding forms and fees for services not listed here.