* * CIRCUIT COURT * FOR * ________________________________ * Civil No.: * Plaintiff IN THE * v. Defendant * * * * * * * * * * * FAMILY SUPPORT SERVICES CHECKLIST Date of Scheduling Conference: __________________ Table 1. Proceedings Scheduled PROCEEDING TYPE SCHEDULED DATE JUDGE/MASTER Emergency Hearing Pendente Lite Hearing Other Hearing - Type:______________ Pretrial Conference Merits Table 2. Services Ordered or Referred Service Provider Date PLAINTIFF Compliance Yes No DEFENDANT Compliance Fee Pd Yes No Fee Pd OTHER:__________ Compliance Yes No Ì Co-parenting Seminar Ì Custody/Visitation ADR Ì Marital Property ADR Ì Child Counsel Ì Nagle v. Hooks Ì GAL Ì Advocate Ì Custody Investigation Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com CM 6 - Revised 2 December 1999 Fee Pd Service Provider Date PLAINTIFF Compliance Yes No DEFENDANT Compliance Fee Pd Yes No Fee Pd OTHER:__________ Compliance Yes No Fee Pd Ì Mental Health Evaluation Ì Substance Abuse Testing Ì Paternity Testing Ì Visitation Services Ì Supervised Visits Ì Monitored Exchange Ì Other:________________ Ì Other:________________ Comments: Family Support Services Coordinator Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com Date CM 6 - Revised 2 December 1999