Custody Evaluation Questionnaire Template Page 12
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2712
Describe History with Other Parent in Dispute With:
Met (when, where), Relationship Before Marriage:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
If married, when and where:
_________________________________________________________________
_________________________________________________________________
Responsibility for Care of Children During Relationship (include
child care providers and description of parents’ employment
during that time):
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
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