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Intake Form -Membership Program
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Untitled Title
First Name
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Last Name
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Pronouns preferred:
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Untitled Section
If you set up an account on your court's portal and would like for me to access it provide your access info (Username and password) and link to the site if you know
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Choose Membership Level: *There is a one-time registration fee.
NOTE: There is a 3-MONTH COMMITMENT TO ADV LEVEL.
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Are you within the US?
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Court Status & Info: please provide court location, court dates, specify what court dates are for and which party filed what.
Sonoma County Court, Santa Rosa California. Only pending date is 6/26/23 for a contempt hearing I filed against my STBX.
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What type of case do you have? Check all that apply.
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Is there history or allegations of ANY type of abuse against you, the other party or the child(ren)? If so, is it documented or reported? Please give details.
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Is there a history of mental illness of any party or child(ren)? Please give specific details.
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Any special circumstances we should know of that can help us to work better with you, i.e. physical, behavioral, neurological limitations, neurodivergent issues, etc.? Please give specific details.
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Are you or have you been, working with a mental health professional? NOTE: This info will help me to come up with the best plan for you, not to be used in any other way.
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Give details on what issues you have been working on with your therapist. NOTE: This info will help me provide the best plan for your specific circumstances, facts and background.
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Would you like for me to speak with your therapist to get more insight on how we can work together? NOTE: If yes, you would have to sign an authorization.
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Is or has the other party working with a mental health professional, to your knowledge?
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Are you working with an attorney? If so, please provide the details. If not, please give history of attorneys you have worked with. For example, how many, complaints, benefits, etc.
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Have you filed any complaints against the judge, any current/previous attorneys, Guardian Ad Litems (attorney for the child) or any other person in your case? If so, please provide details.
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Please provide full details & history of your case. NOTE: If you have a timeline or summary you created you can upload that instead.
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Do you have your court documents? If so, we will need copies of ALL of them.
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Which documents do you have in your possession? Please check all that apply. NOTE: All court petitions, orders and motions pertaining this case are REQUIRED for the initial Meeting. ***TRANSCRIPTS will NOT be reviewed unless a special request is made to have them reviewed. Additional fees will be incurred.***
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If you have a separate case involving child(ren) or issues from a previous or subsequent relationship/marriage, please indicate the status and facts of that case. NOTE: Any additional/separate cases will NOT be considered in the current case unless it's necessary.
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What sort of help are you looking for from Tracey Bee? What do you believe you need help with most? Be specific, by checking all that apply. NOTE: We will recommend the Level best suited for your case based on your responses here as the features differ based on Membership Level.
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What practical tools, apps, software, etc. do you currently use to help you stay organized & prepared? Be specific, by checking all that apply.
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What outcome of the program would make you feel like it has helped you or that you would consider it successful in helping in your case? Please explain in detail what you expect us to accomplish in our time together. (It is advisable to stay in the program for at least 3 months to see real results.)
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We need to get an idea of your needs with respect to getting the support you need. Check the one that applies most:
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What are your triggers? In other words, what gets to emotional, or causes you to react. Check all that apply.
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Check the one that applies most:
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Check the one that applies most:
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Check the one that applies most:
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Check the one that applies most:
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Check the one that applies most:
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Check the one that applies most:
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Check the one that applies most:
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Check the one that applies most:
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Check the one that applies most:
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Why do you think your case is playing out the way it is? Check ALL that apply.
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Which part of the Family Court process is most intimidating as a pro se (self represented) litigant?
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Please share specific details of THE OUTCOME of your case you expect out of this Membership Program? We want to be sure that this is the right fit for you and your case.
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If you are not accepted into the Membership program would you still be interested in our Unbundled Services?
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If Unbundled Service, which one(s)? (Rates for these are at https://thedivorcesolutionist.com/rates-fees)
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You are aware of the fact that I am not representing you in this Membership program, right? The service would be strategic coaching/consulting.
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