Child Custody Questionnaire Template (Page 7 of 7) in pdf

Child Custody Questionnaire Template Page 7

xx.

Serious physical disease (heart condition, cancer, etc.)

xxi.

Physical handicap (blind, crippled, etc.)

xxii.

Alcohol abuse.

xxiii.

Drug abuse (prescription drugs).

xxiv.

Drug abuse (illegal drugs).

xxv.

Intelligence.

xxvi.

Educational attainment.

xxvii. Status is community.

xxviii. Any other factors which you believe may be important.

As to each of the above, what would your spouse say about you? State why you

believe it will or will not be important for the court to consider those factors.

List the five best things your spouse might be able to say about you concerning

your parenting abilities and your relationship with your child.

List the five worst things your spouse might be able to say about you concerning

your parenting abilities and your relationship with your child.

List the five best things you are able to say about your spouse concerning his/her

parenting abilities and his/her relationship with the child.

List the five worst things you are able to say about your spouse concerning

his/her parenting abilities and his/her relationship with the child.

If you believe there will be a custody contest, list the names, addresses and

telephone numbers of:

(i)

All teachers your child has had for the past three years, state when and at

what school.

502 Railroad Avenue, P.O. Box 5263, Traverse City, MI 49696

Tel: 231-929-7744

Fax: 231-929-7766

Child Custody Questionnaire Template Page 7