Inquiries & Intakes | Blake Family Consulting

ALL INQUIRIES MUST BEGIN WITH THIS FORM

Given the nature of our work, a single case may involve communication from both parents, multiple attorneys, and court staff.

To ensure that every inquiry is properly identified, documented, and routed, this form must be completed before our team can answer questions, review a Court Order, confirm availability, or begin services.

Please complete the form whether you:

Have preliminary questions about our services;
Are an attorney, parent, or other professional contacting us regarding a case;
Have already received a Court Order appointing or referring our office; or
Are ready to begin services.

Submitting this form does not guarantee acceptance of the case or establish a professional relationship. Our team will review the information provided and contact you regarding availability and next steps.

Your Name

PLAINTIFF'S DETAILS

If any details are unknown, enter "Unknown" or "N/A."

Plaintiff's First and Last Name:

Plaintiff's Email Address:

Plaintiff's Phone Number:

Plaintiff's Location (City / County):

DEFENDANT'S DETAILS -

If any details are unknown, enter "Unknown" or "N/A."

Defendant's First and Last Name:

Defendant's Email:

Defendant's Phone Number:

Defendant's Location (City):

DETAILS OF CHILD(REN)

Names & Ages of Child(ren):

Case Number / Judge

How are costs split for services (i.e. split equally, one parent pays in full, 65/35, etc.)

What services are you seeking?

Therapy Services

Parenting Time Supervision

Guardian Ad Litem or Parenting Time Coordinator

Parenting Class: Parenting the Love & Logic Way

Any Additional Details?

IF YOU HAVE A SETTLEMENT AGREEMENT OR COURT ORDER FOR SERVICES, PLEASE EMAIL THEM TO BOTH:

LAUREN@BLAKEFAMILYCONSULTING.COM

SAMANTHA@BLAKEFAMILYCONSULTING.COM