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Child Custody Evaluator

1. SHARED PARENTAL RESPONSIBILITY AND PRIMARY RESIDENTIAL CUSTODY IS DETERMINED UPON THE BEST INTEREST OF THE CHILD. PLEASE COMPLETE THE FOLLOWING SERVEY IN ORDER TO MAKE A PRELIMINARY DETERMINATION REGARDING THIS VERY IMPORTANT ISSUE. PLEASE KEEP IN MIND THAT THE COURT'S NOW CONSIDER MOST CUSTODY ARRANGEMENTS ARE BEST WHEN BOTH PARENTS HAVE A MEANINGFUL RELATIONSHIP WITH THEIR CHILDREN. PLEASE HONESTLY PROVIDE YOUR RESPONSE TO THE FOLLOWING QUESTIONS IN ORDER FOR AN HONEST EVALUATION AS TO THE CURRENT STATUS IN ORDER FOR THE RESULTS TO HAVE ANY OBJECTIVE RELEVANCE. ANSWER FROM 1 TO 5 EACH OF THE QUESTIONS FOR BOTH YOU AND THE OTHER PARENT SO THAT THE TOTAL SCORE WILL NEVER EXCEED 5 FOR ANY PARTICULAR QUESTION. THE COURT MUST CONSIDER THESE FACTORS:

  PLEASE CHECK ONE
  MOTHER FATHER

1. THE PARENT WHO IS MORE LIKELY TO ALLOW THE CHILD FREQUENT AND CONTINUED CONTACT WITH THE NONRESIDENTIAL PARENT.

 1. ______ ______

2. THE LOVE, AFFECTION AND OTHER EMOTIONAL TIES EXISTING BETWEEN THE PARENTS AND THE CHILD.

 2. ______ ______

3. THE CAPACITY AND DISPOSITION OF THE PARENTS TO PROVIDE THE CHILD WITH FOOD, CLOTHING, MEDICAL CARE OR OTHER REMEDIAL CARE RECOGNIZED PERMITTED UNDER THE LAWS OF THIS STATE IN LIEU OF MEDICAL CARE AND OTHER MATERIAL NEEDS.

 3. ______ ______

4. THE LENGTH OF TIME THE CHILD HAS LIVED IN A STABLE SATISFACTORY ENVIRONMENT AND THE DESIRABILITY TO MAINTAIN CONTINUITY.

 4. ______ ______

5. THE PERMONENCE AS A FAMILY UNIT OF EXISTING A PROPOSED CUSTODIAL HOME.

 5. ______ ______

6. THE MORAL FITNESS OF THE PARENT

 6. ______ ______

7. THE MENTAL AND PHYCICAL HEALTH OF THE PARENT

 7. ______ ______

8. THE HOME, SCHOOL AND COMMUNITY RECORD OF THE CHILD

 8. ______ ______

9. THE REASONABLE PREFERANCE OF THE CHILD IF THE COURT DEEMS THE CHILD TO BE OF SUFFICIENT INTELLIGENCE, UNDERSTANDING AND EXPERIENCE TO EXPRESS A PREFERANCE

 9. ______ ______

10. THE WILLINGNESS AND ABILITY OF EACH PARENT TO FACILITATE AND ENCOURAGE A CLOSE AND CONTINUING PARENT/CHILD RELATIONSHIP BETWEEN THE CHILD AND THE OTHER PARENT.

 10. ______ ______

11. EVIDENCE THAT ANY PARTY HAS KNOWNLY PROVIDED FALSE INFORMATION TO THE COURT REGARDING A DOMESTIC VIOLENCE PROCEEDING PURSUANT TO SECTION 741.30.

 11. ______ ______

12. EVIDENCE OF DOMESTIC VIOLENCE OR CHILD ABUSE.

 12. ______ ______

13. ANY OTHER FACTS CONSIDERED BY THE COURT TO BE RELIVANT.

 13. ______ ______

TOTALS

      ______ ______

CONFIDENTIALITY NOTICE

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