Sealed Confidential Reports Cover Sheet - Superior Court Of Washington For Thurston County
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1q EXPEDITE
(if filing within 5 court days of hearing)
q
Hearing is set:
Date: ______________________________________
Time: _____________________________________
Judge/Calendar: _____________________________
SUPERIOR COURT OF WASHINGTON
FOR THURSTON COUNTY
FAMILY AND JUVENILE COURT
In re
No.
_______________________________________________
Sealed Confidential Reports
Petitioner(s)
and
(Cover Sheet)
(SEALRPT)
_______________________________________________
Clerk’s Action Required
Respondent(s)
Sealed Confidential Reports
(List documents below and write "Sealed" at least one inch from the top of the first page of each
document.) This cover sheet shall be used to file the sealed portion of the following reports:
CPS Reports created by Family Court
Domestic Violence Assessment Reports
r
r
Services or supplied directly by Children’s
created by Family Court Services or a
Protective Services (RPT)
qualified expert appointed by the court (RPT)
r
Parenting evaluations (RPT)
r
Risk Assessment Reports created by Family
Court Services or a qualified expert (RPT)
r
Reports of Guardian ad Litem or Court
Appointed Special Advocate (RTGAL)
Sexual abuse evaluations (RPT)
r
Declaration of Persons in Household
r
(DCLR)
(3
Party Custody Cases)
rd
r
Other: _________________________________________________________________________
The sealed portion of these reports include: 1) Detailed descriptions of material, or information gathered
or reviewed; 2) Detailed descriptions of all statements reviewed or taken; 3) Detailed descriptions of
tests conducted or reviewed; 4) Analysis to support the conclusions and recommendations.
DATED: _______________________.
Submitted by:
Address: ______________________________
Signature: ____________________________
______________________________
Print Name: ___________________________
Phone No.:
(_______)_________________
NOTICE: The other party may have access to these confidential reports. If you are concerned for your
safety or the safety of the children, you may redact (block out or delete) information that identifies
your location. Other parties may have access to these confidential reports through a court order.
You may also redact the following information: Social security number, driver’s license number,
telephone number, and financial account numbers.
Sealed Confidential Reports (SEALRPT) - Page 1 of 1
WPF DRPSCU 09.0270 (6/2006) - GR 22(e)(1), (2)(B), (f) – 12/30/08
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