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Decision Information
Chapter 40 - Domestic Affairs - cited by 2,497 documents
Rule Set 1 - Rules of Civil Procedure for the District Courts - cited by 4,298 documents
Decision Content
LR2-Form 709. Court clinic referral order.
SECOND JUDICIAL DISTRICT COURT
COUNTY OF BERNALILLO
STATE OF NEW MEXICO
_____________________________________,
Petitioner,
v. No. ____________________
_______________________
_______________________
_______________________,
Respondent.
COURT CLINIC REFERRAL ORDER
THIS MATTER came before the court and the court having determined that the parties need assistance in resolving custody and timesharing issues and that participating in court clinic services is in the best interests of the parties’ child(ren), the court FINDS:
1. The above referenced case involves the following child(ren):
(Name (first, last) Age Year of birth
________________________ (_____) ___________
________________________ (_____) ___________
________________________ (_____) ___________
________________________ (_____) ___________
2. The parties shall participate in the following court clinic services:
a. ( ) Mediation under NMSA 1978, § 40-12-3(F). If the parties are unable to reach a full or partial agreement, the court clinic shall
i. [ ] notify the court and request a hearing on concluded mediation; or
ii. [ ] provide an additional service as indicated below.
b. ( ) The court needs additional information under NMSA 1978,
§ 40-4-9.1 in order to determine the best interest(s) of the child(ren). The parties are ordered to fully participate in the following service:
i. ( ) advisory consultation under NMSA 1978, § 40-12-3(A);
ii. ( ) priority consultation under NMSA 1978, § 40-12-3(C) with a written recommendation under Rule 1-125 NMRA;
iii. ( ) scheduled consultation with recommendations presented by testimony at a report back hearing under LR2-401;
c. ( ) The court clinic shall address the following issues:
[ ] legal custody [ ] relocation
[ ] timesharing/visitation [ ] safety concerns
[ ] communication issues [ ] educational concerns
[ ] grandparent visitation [ ] criminal history
[ ] domestic abuse [ ] mental health concerns
[ ] substance use/abuse
[ ] reunification between: ___________________________
[ ] other:
_______________________________________ .
IT IS THEREFORE ORDERED:
1. The parties and their child(ren) shall participate in court clinic services as set forth herein.
2. If either party fails to comply with this referral order, the court clinic shall file a notice of noncompliance. The court may schedule a hearing and impose sanctions as may be appropriate.
3. If either party files objections to a parenting plan or recommendations, the parties are to follow the prior order on custody and timesharing until the hearing on the objections and further order of the court.
4. Supplemental information. The following applies only if the parties are referred for a scheduled consultation, priority consultation, or advisory consultation.
a. The petitioner (P) and/or respondent (R) shall provide the following records to the court clinic at their first appointment (indicate P and/or R to provide as applicable):
_____ medical/psychiatric hospitalization and/or dental records
_____ daycare/school records
_____ all records from Child Protective Services (CYFD)
_____ psychiatric/psychological/neuropsychological/psychosexual evaluations and/or reports
_____ supervising agency logs
_____ drug test results
_____ academic/school assessment reports (IEP)
_____ police reports
_____ other: __________________________________________________.
b. The court clinic shall consult with and receive information from individuals and agencies deemed necessary by the court clinic.
5. Questionnaire. Parties will receive a questionnaire from the court clinic that should be completed and returned to the clinic at least one week prior to the date of service.
6. Notice of appointment for court clinic services.
( ) A date and time to be set by the court clinic (notice will be mailed to all parties ordered to court clinic services);
( ) The parties shall participate in their scheduled appointment on ________________ (date) at the court clinic (Second Judicial District Court, 2nd Floor, Room 210). Notice of appointment date and time will be mailed to all parties ordered to court clinic services.
7. Hearing.
( ) A hearing date and time will be sent by the court, if appropriate;
( ) The parties and the court clinician shall report to the court for a hearing scheduled on ______________________ at ___________ a.m./p.m.
8. Fees.
a. Advisory consultation fees. The parties shall pay required fees as follows:
$______________ Petitioner
$______________ Respondent
$______________ Other
The court clinic shall not schedule services until advisory consultation fees are paid in full by both parties.
b. Priority consultation/scheduled consultation fees. The parties shall pay required fees as follows:
$______________ Petitioner
$______________ Respondent
$______________ Other
Payment can only be made with cash or money order on the day of the appointment. Parties shall check in with the court clinic prior to making the payment.
9. Confidentiality of file. The court clinic file (including but not limited to documents, reports, testing materials and results, and notes) is confidential and information contained in the file shall not be disclosed other than by a clinician testifying in the above referenced case or by order of the court.
10. Notification of agreement. The parties shall notify the court clinic if an agreement is reached by the parties and shall provide the court clinic with any order that disposes of any issue in this case.
11. Interpreter.
( ) One or more party requires an interpreter.
( ) Petitioner. Language: ___________________________
( ) Respondent. Language: _________________________
Reviewed/approved by:
_____________________________ _____________________________
Petitioner/Counsel for Petitioner Respondent/Counsel for Respondent
Approved by:
_____________________________
COMMISSIONER/
HEARING OFFICER
_____________________________
DISTRICT COURT JUDGE
COURT CLINIC REFERRAL ORDER
INFORMATION SHEET
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Petitioner |
Respondent |
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Name (Please print)
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Year of birth
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Address
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City, State, ZIP
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Email address (one that you use frequently) |
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Telephone: Home Cell Work |
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Attorney’s name
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Address
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City, State, ZIP
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Telephone
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Gross monthly income |
$_____________________ |
$___________________
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I state that the above information is true and correct. I have completely filled in all information. I understand that failure to complete all information will cause delay in services and may result in a notice of noncompliance against me. I agree to pay the Second Judicial District Court my share of any fees for court clinic services. I understand that false statements or failure to pay fees may be grounds for contempt proceedings.
________________________________ ________________________________
Signature of Petitioner Signature of Respondent
________________________________ ________________________________
Date Date
[As amended by Supreme Court Order No. 09-8300-012, effective May 18, 2009; LR2-Form T recompiled as LR2-Form 709 by Supreme Court Order No. 16-8300-015, effective for all cases pending or filed on or after December 31, 2016; as amended by Supreme Court Order No. 18-8300-006, effective for all cases pending or filed on or after September 1, 2018.]