Intake Form

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SNO-KING VISITATION

Supervised visitation and related service

425-931-5131

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Thank you for contacting SNO KING VISITATION. We look forward to working with you.

City and Zip

Parental Status:

Other Parent:

Children:

Are any of your children in counseling? *

Yes

Maybe

Please explain:

Emergency Contacts:

Attorney:

Guardian ad Litem:

Why is supervision required?

Please describe the nature of limitations for the visiting parent?

Specific instructions for child care (allergies, fears, etc):

Based on the court order, who can be present for visits?

Is there a specific location in the court order? *

Yes

Maybe

Instructions, restraining orders, or protection orders?

What behaviors should the supervisor look for?

Are there any restrictions in the Court Order for visits? *

Yes

Maybe

Is the visiting parent a flight risk? *

Yes

Maybe

Please explain (Court Order):

Has the visiting parent ever been arrested? *

Yes

Maybe

Does the visiting parent have a weapon in their residence? *

Yes

Maybe

Does the visiting parent have a concealed weapon permit? *

Yes

Maybe

If yes, please explain:

Has the visiting parent ever been treated for mental illness? *

Yes

Maybe

Please explain:

What days and times will the visits take place?

How many hours is needed for the visits per week?

May the other parent have your contact information? *

Yes

Are you in need of any of the following? (please select all that apply)

In-Home Visits

Community Visits

Visitation Suite

Please add any additional comments or concerns not covered:

Please upload documents here:

Upload File

Max File Size 15MB

Upload File

Max File Size 15MB

Thank You!

sno-king@outlook.com

425-931-5131

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Intake Form

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Thank you for contacting SNO KING VISITATION. We look forward to working with you.