Custody Evaluation Questionnaire Template Page 27
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2727
I.
STEPPARENT OR OTHER HOUSEHOLD MEMBER INFORMATION:
If you have remarried or if you now share or plan to share your
home with another adult, please complete the following questions
in regard to the other adult.
Name: __________________________________________________________
Age: _______
Phone Number: ________________________________
Occupation: ____________________________________________________
Relationship to You: ______________________________________________
_________________________________________________________________
_________________________________________________________________
Names and ages of this person’s children:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
This Person’s Relationship with the Child/Children at Issue:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
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