Wallacker Family Law | Mediation & Consulting
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Divorce or Legal Separation

Mediator / Private Settlement Judge

Confidential Initial Consultation Intake Form: Please complete all fields below that apply to you and your matter. This information will be used to run a conflict of interest check through our system and will be kept confidential. Not all fields will apply to your matter. If there is no conflict of interest and Gretchen is available to meet with you, Jeffrey will email you and the other party involved in the matter to schedule your initial consultation.

Step 1 of 3

Mediator or Settlement Judge?

Please indicate whether you are interested in having Gretchen serve as your Mediator or Private Settlement Judge.(Required)
Please select your preferred consulation type.(Required)

PARTY #1

Full legal name(Required)
Current home address(Required)
Maiden name or any name(s) used from former relationships
The name(s) of your former spouse(s)
First
Middle
Last
 
The name of your current spouse
The name of your current fiancé
The name(s) of your current spouse’s former spouse(s)
First
Middle
Last
 
The name(s) of your current fiancé’s former spouse(s)
First
Middle
Last
 
If employed, the name of your company and job title
If you have one, the name of your attorney
If you have an attorney, would you like them to attend your mediation sessions?