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Get And Sign OFF SITE FAMILY MEDIATION INTAKE FORM

To be the greatest obstacle in reaching an agreement in mediation Indicate the reasons that best explain your reasons for separating Physical abuse / violence Poor Communication Threats Emotional abuse Drugs / alcohol abuse Incompatibility Mental illness Great deal of conflict Infidelity Taking advantage of the person Conflict about pets Is there any a Police File b Children s Aid Society file Other Do you have any disabilities you would like us to know about Are you living in the same house as...

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