VIEWS OF THE CHILD REPORTING INTAKE FORM

First Name *

Last Name *

Phone Number *

E-mail Address *

Street Address *

Apartment, suite, etc... *

City *

Province *

Postal Code *

What are your preferred pronouns/how do you like to be addressed?

How did you hear about me and my services? *

How do you wish to be contacted? *

Do you have legal representation? *YesNo

Please provide the name and contact information for your legal counsel.

First Name *

Last Name *

Phone Number *

E-mail Address *

What is the name of the opposing party?

First Name *

Last Name *

Does the opposing party have legal representation? *YesNo

Please provide the name of the opposing party's legal counsel.

First Name *

Last Name *

Has Views of the Child Reporting been court-ordered or otherwise formally agreed upon? *YesNo

Please upload the applicable order(s) or agreement(s). *

No file chosen

Have all parents/legal guardians provided their consent for Views of the Child Reporting to take place? *YesNo

Please provide the full legal name of the child.

First Name *

Middle Name *

Last Name *

What is the child's date of birth? *

Month

Day

Year

Please provide the full legal name of the second child.

First Name *

Middle Name *

Last Name *

What is the second child's date of birth? *

Month

Day

Year

Please provide the full legal name of the third child.

First Name *

Middle Name *

Last Name *

What is the third child's date of birth? *

Month

Day

Year

Please provide the full legal name of the fourth child.

First Name *

Middle Name *

Last Name *

What is the fourth child's date of birth? *

Month

Day

Year

Please provide the full legal name of the fifth child.

First Name *

Middle Name *

Last Name *

What is the fifth child's date of birth? *

Month

Day

Year

When is the final Views of the Child Reporting required to be submitted? Please note the time requirements in advance of a trial or court appearance for which the reporting will need to be provided. *

Month

Day

Year

Have the court(s) or the parties in the file determined cost-sharing? *YesNo

What is the cost-sharing arrangement? *

Is financing secured for this service in order to provide a retainer? *YesNo

Do both parents/legal guardians intend to participate in the parent intake component of the Views of the Child Report preparation? *YesNo

Please provide an explanation as to why one or more parents/legal guardians do not intend to participate. *

Do you have all applicable documentation readily available should your file be accepted (i.e. court/consent orders for the preparation of a Views of the Child Report, court/consent orders for parenting access/arrangements, separation agreements, letters of instruction from legal counsel, etc...) to disclose to the report writer? *YesNo

Have you reviewed the most recent Fee Schedule? *YesNo

Please review the most recent Fee Schedule on the Resources page.

Resources

Have you reviewed the sample Professional Services Agreement you would be expected to sign? *YesNo

Please review the sample Professional Services Agreeement on the Resources page.

Resources

Have you reviewed the sample Non-Disclosure Agreement you would be expected to sign? *YesNo

Please review the sample Non-Disclosure Agreeement on the Resources page.

Resources

Leanne Toews acknowledges that her work takes place primarily on the unceded Coast Salish Territory of the Lekwungen and W̱SÁNEĆ nations, and that the areas she additionally serves across British Columbia possess a complex history for which she has the utmost respect, appreciation, and gratitude.

The regulatory body for general counselling services Leanne provides is the British Columbia Association of Clinical Counsellors (BCACC). Please visit their website by clicking on their name to learn more about what they do and what services and options may be available to you.