| Parenting Coordinator Agreement PARENTING COORDINATOR AGREEMENT
In Re: Plaintiff
v.
Defendant
Docket No:
Name:
Address:
Telephone: _______________________ Wk: _____________________________
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1) I understand that Patricia Brady has been appointed in a formal order/stipulation by Justice _______________________, in the matter pending in the ____________________Probate and Family Court. This appointment includes a specific statement regarding who is responsible for paying for the evaluation. Insurance is not applicable to Court ordered Parenting Coordinators. 2) Upon the signing of this agreement, and the payment in advance of a retainer representing twenty hours of work at a rate of $150 per hour, in the amount of $3000, with the parties being responsible as follows: Plaintiff pays one third and the Defendant pays two thirds. Ms. Brady will contact the parties and meet with them and any third parties, who in her opinion would be necessary and helpful in her role as Parenting Coordinator. Third party contacts include: medical providers, psychotherapists, employers, educational providers and any other individual deemed necessary. Once the retainer has been exhausted, monthly bills will be forwarded to each client, itemizing the services rendered. 3) It is my practice to discuss particular cases or aspects of cases with colleagues experienced in particular clinical areas in an effort to enhance the quality of services provided. In such professional consultations, every effort will be made to preserve the privacy and confidentiality of the parties. Parenting Coordinator Agreement Page 2
4) If the Parenting Coordinator determines that a child or adult party may be at risk due to the current custody or visitation arrangement in place, each party will be notified in writing and or by telephone. In addition the Parenting Coordinator may take other actions to notify responsible agencies in order to reduce the likelihood of harm as required by law. As a mandated reporter, the Parenting Coordinator is bound by law to inform appropriate authorities (e.g. DSS) if there is a reasonable basis to believe that a child is suffering or in danger of some form of abuse or neglect. 5) The Parenting Coordinator is required by law to take protective action if she believes that any individual is threatening serious harm to another. Such action may include notifying the police and or the person about whom the threat was made. If any family member appears to be a serious risk to harm him or herself, she may be required to release information in order to seek hospitalization or to contact others who can help provide protection. 6) As ordered by the Court Middlesex Probate and Family Court, I agree to pay Patricia Brady, in her role as Parenting Coordinator at the rate of $150 per hour for services rendered including but not limited to time spent traveling, phone conferences, personal interviews, mail or electronic communications with attorneys or necessary third parties, travel, attendance at visitation and transportation between visits involving the child, testimony at depositions, report preparation and court appearances, trial preparation, and testimony in a court proceeding. 7) This contract and its signing will be effective December 11, 2006. 8) I understand that if a scheduled appointment is canceled with less than 24 hours notice a fee may be charged to the party who cancels commensurate with the amount of time scheduled for that day. If you fail to appear for a scheduled appointment, that person shall be responsible for the entire cost of the scheduled time at the discretion of the Parenting Coordinator. Parenting Coordinator Agreement Page 3
I have read the above agreement and have had the opportunity to discuss it with my attorney if so wished. If for any reason you are uncomfortable about any of the procedures and requirements described herein, please discuss your questions and concerns with Ms. Brady in addition to seeking consultation with counsel prior to signing this document. I enter into this contract with the full understanding that Patricia Brady, M.S. has been appointed by the Middlesex County Probate and Family Court. Printed Name: ________________________________________ Signature: _________________________________________ Date: __________ Witness: ________________________________________ Parenting Coordinator _____________________________________________ | |
