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Co-Parenting Solutions

Jordana Wolfson / June 7, 2023

MAKEUP TIME

Things happen with Parenting Time and sometimes, parents have to miss an hour or two here or there. So do they get to make it up? If you forfeit Parenting …

[Read more...] about MAKEUP TIME

Jordana Wolfson / February 27, 2023

The Impact of Co-Parenting Counseling

While parents come to me for co-parenting counseling when they don’t know what else to do – or because the court has ordered them to – co-parenting counseling …

Jordana Wolfson / January 25, 2023

How Divorced Parents Can Best Set Kids Up for Success

I’ve heard too many times from divorced parents that they don’t want to take their children to an activity, work on homework or a school project or do some …

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Co-Parenting Solutions
Jamestowne Executive Offices
31000 Telegraph Rd., Ste 280
Bingham Farms, MI 48025

248.330.5351
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Co-Parenting Solutions provides a multi-level approach to services that focuses on reducing parental conflict in order to enhance the child’s emotional functioning. Co-Parenting Solutions offers programs to address the relationship between separate households created as a result of separation or divorce.

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Collaborative Divorce with Mental Health Professional Agreement

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Test Agreement

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Consent for In-Person Services During Covid-19 Public Health Crisis

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Name of client or person acting as legal representative for the purposes of this agreement.
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Email address of client or representative for purposes of this agreement.
Minor Name (if also applicable)
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Client Relationship to Minor Child (if also applicable)
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Client Intake Form

Step 1 of 3

33%

Client Name (Self)*
First Last
Name of Your Co-Parent
First Last
Mobile*
Work*
Email*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Place of Employment and Title*

How did you hear about Co-Parenting Solutions, LLC?*
Name of Therapist(s) Used for Self (if applicable)
Name(s) of Therapist(s) You Have Engaged the Services of for your Children (If Applicable)
Names of Any Legal Professionals You Have Engaged for Divorce Services
Which judge is assigned to your case?

List any professionals from Friend of the Court you are working with
Names and Ages of Shared Children
Please list shared children name(s) and age(s), one per line.
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Contract for Mediation Services

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Contract for Court-Related Services

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Contract for Co-Parenting Counseling and Skill Building Sessions

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Consent for Therapeutic Treatment

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Consent for Minor Therapeutic Treatment

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Additional Minor Names:
Please add the first and last names, one per line, for each additional minor covered by this agreement.
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Authorization to Release Confidential Information

Step 1 of 2 - Client / Signer Information

50%

Client Name*
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Client Email*
Minor Name(s) and DOB (if also applicable)
One minor name and dob per line.
Maiden / Other Name
Client Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Source of Authority (if acting as legal representative of client)

This information will be released to Jordana Wolfson, LMSW, MA, ED SP, of Co-Parenting Solutions, LLC.
Person / Agency Releasing Information
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Person / Agency Releasing Information #2
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Information to be Released
This authorization is in effect for up to 5 years from date of signature unless you rescind same in writing to Jordana Wolfson, 31000 Telegraph Road, Suite 280, Bingham Farms, MI 48025.
Description of Information to be Released
- Co-Parenting Counseling
- Parenting Coordination
- Parent-Child Reunification Therapy
- Collaborative Divorce
- Parenting Time Agreement
- Divorce Mediation
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The Purpose and Need for Disclosure of Information
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Authorization for Teletherapy

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Credit Card on File Policy

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If your credit card is declined two consecutive times, we will be requesting a retainer before proceeding with new appointments.*
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Notice of Privacy

Client Name*
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Name of client or person acting as legal representative for the purposes of this agreement.
Client Email Address*

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Client Date of Birth*
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Minor Name (if also applicable)
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Client Relationship to Minor (if also applicable):
Minor Date of Birth (if also applicable):
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