Custody Coaching Intake Form

    Your Name (required)

    Your E-mail (required)

    Your Telephone # (only used upon request)

    Are you a married, unmarried, or divorced Father?

    What City & State do you live in?

    Do you and the Mother reside in the same residence?

    If not, what City & State does the Mother live in?

    Where (City, State) have your children lived for the past 6 months?

    How old are your children?

    How many nights do the children reside with you?

    Do you currently have a parenting agreement?

    Please summarize the main issues you are facing in your custody dispute:

    How do you prefer that I communicate with you?

    By checking the box below, you agree that you have read the Disclaimer and full Terms of Service and understand that our coaching services are not considered legal advice.

    Please type your full name below as your digital signature affirming your agreement to the terms of service.


    NOTHING CONTAINED HEREIN SHOULD BE CONSTRUED AS LEGAL ADVICE. All material and content in writing, audio, or video delivered via or, within the Fathers’ Rights Simplified resource books, email, or personal coaching sessions is meant for informational purposes only and not intended to serve as (or be a substitute for) legal, financial, and/or tax advice. Use of the information and/or materials as a basis for any legal, medical, or financial decision by the User/Visitor, is done strictly at the User/Visitor’s sole risk. No warranties or representations of any kind are made to the User or Visitor regarding the information and/or materials. No responsibility or liability is assumed by Fathers’ Rights Simplified, Fathering Families, it’s employees or affiliates. Laws may change over time and differ in your County, State, or Country. It is recommended that you seek counsel of a qualified attorney before taking any action. Please review our full Terms of Service prior to reading any material or using our services.