FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF CONTRA COSTA 751 PINE STREET P.O. BOX 911 MARTINEZ, CA 94553 PETITIONER/PLAINTIFF:__________________________________________________________ _______________________________________________________________________________ Street _______________________________________________________________________________ City/State/Zip _______________________________________________________________________________ Telephone Number RESPONDENT / DEFENDANT:______________________________________________________ _______________________________________________________________________________ Street _______________________________________________________________________________ City/State/Zip _______________________________________________________________________________ Telephone Number ORDER FOR SUBSTANCE ABUSE ASSESSMENT / TESTING CASE NO.: ________________________ Based on the entire court record in this matter, the court hereby finds that the custody dispute between the parents poses a substantial danger to the best interest of the child and that a counseling order directing a substance abuse assessment/testing, is in the best interest of the child, and that the financial burden for such does not jeopardize the party’s other financial obligations. It is hereby ordered that: ____________________________________________________________________________________________________ First Name Last Name Street City State Zip is hereby appointed as the Court’s expert pursuant to Evidence Code Section 730 and FC 3190 to: prepare a written substance abuse assessment report regarding: petitioner respondent The report shall have a particular focus on _______________________________________________________________________ conduct random testing alcohol only alcohol and all other drugs regarding: conduct hair follicle test with a written report regarding: petitioner petitioner respondent respondent The cost of the report shall be advanced by: Petitioner Respondent. Jurisdiction over final allocation of payment is reserved. Petitioner Respondent SHALL IMMEDIATELY SERVE THE COURT’S EXPERT WITH A COPY OF THIS ORDER AND SHALL CONTACT THE EXPERT FOR AN APPOINTMENT WITHIN FIVE (5) DAYS OF THE FILING OF THIS ORDER. The next court date in this matter is on __________________________. The expert shall submit a report within 30 days of payment. Should payment be late, the expert will notify the court in writing. The expert shall distribute copies of the report to: Petitioner Respondent Petitioner’s Counsel Family Court Services (751 Pine St., Martinez, CA 94553) Respondent’s Counsel Custody Evaluator ____________________________________________________________________________________________ Name Address Minor’s Counsel ______________________________________________________________________________________________ SO ORDERED: Name Dated: ___________________________ Address _______________________________________________________ Judge/Commissioner-Judge Pro Tem DISTRIBUTION: FAMLAW-13/DT/Rev. 6-13-03 WHITE (Original) - Petitioner GREEN - Respondent PINK - Substance Abuse Expert CANARY - Family Court Services GOLDENROD - Private Evaluator (if any) American LegalNet, Inc. www.FormsWorkFlow.com