Custody Evaluation Questionnaire Template Page 11
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2711
E.
MARITAL AND RELATIONSHIP HISTORY
List all your marriages (and relationships that produced children):
Name of Spouse Date of
Date & How
Number of
____________or Partner
Marriage
Terminated __
Children________
______________________________________________________________
First
___________________________________________________________
Second
_____________________________________________________________
Third
Are you remarried:
YES____________
NO____________
If yes, please give name (and ask spouse to complete stepparent
questionnaire):
_________________________________________________________________
If No, are you in a relationship: YES_______ NO_______
If Yes, please give name and age of person and describe your
relationship (dating, committed, engaged, etc.) and how much
time you spend together and how much time that person spends
around the children:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
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