Follow the steps to fill out the form with ease.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of the county where you are filing this case in the designated field.
3. Select the appropriate checkbox to indicate whether you are seeking mediation for a marriage or paternity matter. If you are addressing paternity, include the initials of the child in the specified field.
4. In the next section, enter the name of Petitioner/Joint Petitioner A, providing their first, middle, and last names as requested.
5. Proceed to enter the name of Respondent/Joint Petitioner B, again inputting their full name.
6. Fill in the case number in the provided space.
7. Enter your name, address, and phone numbers, ensuring that all information is correct for accurate communication.
8. Clearly describe the issues you are experiencing with the current physical placement or legal custody order in the provided section. If more space is needed, you may add additional pages.
9. Input the name, address, and phone numbers of the other party or parties involved in the case.
10. Indicate your relationship to the parent of the child or children and any other person with a court-ordered placement, if applicable.
11. Complete the request for mediation by detailing the specific problems you wish to resolve regarding legal custody and/or physical placement.
12. Sign and print your name at the signature line designated for your confirmation.
13. Enter the date on which you signed the form in the specified field.
14. Finally, save your changes, then download, print, or share the form as needed.

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