Notice Of Confidential Information Within Court Filing Form - First Judicialcircuit - Walton County, Florida Page 2
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Records of substance abuse service providers which pertain to the identity, diagnosis, and prognosis of and
service provision to individuals who have received services from substance abuse service providers. §
397.501(7), Fla. Stat.
Location: ______________________________________________________________________________
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Identifying information in clinical records of detained criminal defendants found incompetent to proceed or
acquitted by reason of insanity. § 916.107(8), Fla. Stat.
Location: ______________________________________________________________________________
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Estate inventories and accountings. § 733.604(1), Fla. Stat.
Location: _____________________________________________________________________________
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Victim’s address in domestic violence action on petitioner’s request. § 741.30(3)(b), Fla. Stat.
Location: _____________________________________________________________________________
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Information identifying victims of sexual offenses, including child sexual abuse. §§ 119.071(2)(h),
119.0714(1)(h), Fla. Stat.
Location: _____________________________________________________________________________
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Gestational surrogacy records. § 742.16(9), Fla. Stat.
Location: _____________________________________________________________________________
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Guardianship records and orders appointing court monitors in guardianship cases. §§ 744.1076, 744.3701,
Fla. Stat.
Location: ______________________________________________________________________________
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Grand jury records. Ch. 905, Fla. Stat. (If the document is filed in a Ch. 905 grand jury proceeding, this form
is not required.)
Location: _____________________________________________________________________________
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Information acquired by courts and law enforcement regarding family services for children. § 984.06(3)-(4),
Fla. Stat. (If the document is filed in a Ch. 984 family services for children case, this form is not required.)
Location: _____________________________________________________________________________
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Juvenile delinquency records. §§ 985.04(1), 985.045(2), Fla. Stat. (If the document is filed in a Ch. 985
juvenile delinquency case, this form is not required.)
Location: ______________________________________________________________________________
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Information disclosing the identity of persons subject to tuberculosis proceedings and records of the
Department of Health in suspected tuberculosis cases. §§ 392.545, 392.65, Fla. Stat.
Location: _____________________________________________________________________________
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a copy of the foregoing was furnished by U.S. mail / personal service to:
___________________________________, on __________________, 20___.
________________________________
Attorney Name
Address
Phone
Florida Bar No. .......................................
Note: The clerk of court shall review filings identified as containing confidential information to determine whether
the information is facially subject to confidentiality under the identified provision. The clerk shall notify the filer in
writing within 5 days if the clerk determines that the information is NOT subject to confidentiality, and the records
shall not be held as confidential for more than 10 days, unless a motion is filed pursuant to subdivision (d)(3) of
the Rule. Fla. R. Jud. Admin. 2.2420(d)(2).
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