Wallacker Family Law | Mediation & Consulting

Divorce or Legal Separation

Mediation or 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.

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)

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?