J C \ E - 324 Rev. 5/24/2013 STIPULATION AND REQUEST FOR ORDER FOLLOWING MEET AND CONFER Page 1 of 2 ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name, State Bar number and address): TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF SACRAMENTO STREET ADDRESS: 3341 Power Inn Road, MAILING ADDRESS: William R. Ridgeway Family Relations Courthouse CITY AND ZIP CODE: Sacramento, CA 95826 BRANCH NAME: Sitting as the J uvenile Court CHILD(REN)222S NAMES: CASE NUMBER(S): STIPULATION AND REQUEST FOR ORDER FOLLOWING MEET AND CONFER DEPARTMENT: A. Request and Declaration of Attorney: I , attorney for (name) , declare that I have met and conferred with all counsel listed in section B of this form regarding the following requests and request an order: 1. Counseling Referral for (nam e) , to complete (counseling service or type) 2 Medication Referral for (name) 3. Medical or Dental Referral for (name) , for (speci f y service(s ) ): 4. Visitation with: Mother Father Sibling Uncle (name): Aunt (name): Maternal grandmother/grandfather (name): Paternal grandmother/grandfather (name): Other (specify): Visitation Orders (spe cify): 5. Home evaluation of the following relatives or NREFM for detention or placement: Name of Relative: Relationship: American LegalNet, Inc. www.FormsWorkFlow.com J C \ E - 324 Rev. 5/24/2013 STIPULATION AND REQUEST FOR ORDER FOLLOWING MEET AND CONFER Page 2 of 2 Case Name(s) : C ase Number(s): 6. Referrals for the following reunifications services (list): (a) (b) (c) (d) 7. Discove r y of (specify) 8. Other (specify) : B. Response of Parties in the Case: I have sent a copy of my request to the parties listed below, as applicable. Based on their responses, I have checked the correct boxes below to show whether the parties agree with my request; or I reviewed this request with them in person and they have indicated their response by checking the boxes and signing below: Attorney for: Name: Agree Or Obtained Attorney222s Signature Child(ren) County Parent Parent C. Continuance of Hearing: Continuance is requested for the following good cause (specify): . All parties further agree to continue the (hearing type) hearing, scheduled on (date) to the following: Date Time Department D. Signature of Attorney I declare under penalty of perjury under the laws of the State of California that the information in this form is true and correct to my knowledge. Date Type Name Signature of Moving Party American LegalNet, Inc. www.FormsWorkFlow.com