LASC-FCS-047LocalFillable

Confidential Mediation Form

Los Angeles Superior Court · Family Law

This form was updated 51 days ago — make sure you're using the latest version.

Last updated August 22, 2026

Intake questionnaire completed by a parent involved in a child custody or parenting time dispute, submitted before a Family Court Services mediation or Child Custody Recommending Counseling appointment to provide background information.

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