Confidential Divorce Questionnaire Template Page 3
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4Abraham & Zoticus, PC
Confidential Divorce Questionnaire
Page 3
c.
Have
t here
b een
p rior
s eparations?
Y es
N o
If
s o,
h ow
m any?
Approximately
w hen
a nd
f or
h ow
l ong?
10.
Answer
o nly
i f
y ou
a re
a lready
d ivorced
a nd
s eeking
a
m odification:
a.
What
i s
t he
d ate
o f
y our
d ivorce
d ecree?
b.
In
w hat
c ounty
d id
y our
d ivorce
o ccur?
c.
Have
a ny
o rders
b een
e ntered
m odifying
t he
o riginal
d ecree?
Y es
N o
d.
Please
a ttach
a
c opy
o f
y our
d ivorce
d ecree
a nd
a ny
m odification
o rders.
11.
Custody
a.
Who
n ow
h as
p hysical
c ustody
o f
t he
c hild(ren)?
You
Spouse
b.
Are
y ou
s eeking
c ustody
o f
t he
c hild(ren)
o f
t his
m arriage?
Y es
N o
c.
Are
a ny
o f
t he
c hildren
a dopted?
Y es
N o
d.
Are
t here
a ny
r estraining
o rders
o r
a ny
o ther
t ype
o f
c ustody
o rder
c urrently
in
e ffect
o r
p ending?
Y es
N o
12.
Support
a.
Are
y ou
n ow
p aying
s upport?
Y es
N o
If
s o,
h ow
m uch
$
b.
Are
y ou
n ow
r eceiving
s upport?
Y es
N o
If
s o,
h ow
m uch
$
c.
Are
y ou
o r
i s
y our
s pouse
n ow
r eceiving
a ny
f orm
o f
p ublic
a ssistance?
Y es
N o
d.
Other
t han
c hildren,
d o
y ou
h ave
a ny
d ependents?
Y es
N o
13.
Health
o f
P arties
a.
Is
t here
a nything
w e
s hould
k now
a bout
t he
m ental
o r
p hysical
h ealth
o f
a ny
party
t o
t his
a ction?
Y es
N o
b.
Do
a ny
o f
y our
c hildren
h ave
e xceptional
h ealth
o r
d ental
n eeds?
Y es
N o
c.
Does
a ny
c hild
h ave
a ny
s pecial
e ducational
n eeds
o r
p roblems?
Y es
N o
14.
Are
y ou
o r
y our
s pouse
n ow
i n
t he
U .
S .
A rmed
F orces?
Y es
N o
15.
Does
y our
s pouse
h ave
a n
a ttorney?
Y es
N o
Who?
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