CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT 251 WHEATON, ILLINOIS 60187-0707 JOINT EVALUATION REFERRAL 3238 (Rev. 5/19) File Stamp HereJOINT EVALUATION REFERRALCASE NUMBER UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUITPETITIONER RESPONDENTIN RE THE MARRIAGE OFvs PAGE 1 OF 2Attended MediationMOTHER AgeCHILD(REN)Business Telephone City State Zip Address Name Date of Divorce Pre-Judgment CaseDate of Separation Date of Marriage No Yes No Yes Telephone Business Telephone Telephone City State Zip Address Name Address City State Zip Telephone Name Name Name Age Age Age Age Name Name Name AgeAgeAge FATHER American LegalNet, Inc. www.FormsWorkFlow.com CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT 251 WHEATON, ILLINOIS 60187-0707 JOINT EVALUATION REFERRAL 3238 (Rev. 5/19)PAGE 2 OF 2 Child(ren) Dissolution of Marriage Arrange for the parties to arrive / depart separately Copies will be submitted Do not allow parties to be present at the same timeCase # None currently pending Dated Other Visitation Removal Custody Temporary Visitation Temporary Custody Permanent Custody Name Telephone Telephone Telephone FatherTelephone MotherATTORNEYSGUARDIANLEGAL DECISIONS COMPLETED (please check all that apply)LEGAL ISSUES PENDING (please check all that apply) ISSUES TO BE EVALUATEDTO BE SUBMITTED TO EVALUATOR ORDERS OF PROTECTIONRESPONDENTPETITIONER This form is to be completed by all parties or their attorneys Name: DuPage Attorney Number: Attorney for: Address: City/State/Zip: Telephone Number: Pro SeEmail: Name: DuPage Attorney Number: Attorney for: Address: City/State/Zip: Telephone Number: Pro SeEmail: American LegalNet, Inc. www.FormsWorkFlow.com American LegalNet, Inc. www.FormsWorkFlow.com