Illinois > Local County > Cook > Domestic Relations
Circuit Court Rule 13.4(f) Consolidated Referral Order CCDR 0009 - Illinois
| Circuit Court Rule 13.4(f) Consolidated Referral Order Form. This is a Illinois form and can be used in Domestic Relations Cook Local County . |
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Print Form Clear Form 4215 4617 4253 4618 4406 4619 4572 4620 4574 4621 4578 4622 4623 7288 7289 (Rev. 8/18/12) CCDR 0009 A IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, DOMESTIC RELATIONS DIVISION IN RE THE: MARRIAGE VISITATION CIVIL UNION CUSTODY PARENTAGE OF NO: ____________________________ CALENDAR: _____________________ _____________________________________________ PETITIONER AND PREJUDGMENT POST JUDGMENT _____________________________________________ RESPONDENT CIRCUIT COURT RULE 13.4(f) CONSOLIDATED REFERRAL ORDER: CONTESTED CUSTODY/VISITATION EDUCATIONAL PROGRAM, ILLINOIS MARRIAGE AND DISSOLUTION OF MARRIAGE ACT THIS MATTER having been represented as involving custody and/or visitation of the child(ren) of the parties, IT IS HEREBY ORDERED that the matter is referred as follows: A. TYPE OF REFERRAL AND AGENCY FOCUS ON CHILDREN parent education program (FOCUS); George W. Dunne Building, 69 W. Washington, Suite 1000, Chicago, IL 60602; Telephone: (312) 603-1550 FAX: (312) 603-1588 or Suburban Municipal District ________ located at ____________________________________________________ For Petitioner Respondent Focus Class in Spanish 7288 7289 Focus on Children fee assessed for attendance, to be collected by the Clerk of the Circuit Court of Cook County is: $25.00 $ Set at ____________ Waived To be paid by Petitioner Respondent 4578 Marriage and Family Counseling Service (MFCS); George W. Dunne Building, 69 W. Washington, Suite 1000, Chicago, IL 60602; Telephone: (312) 603-1540 FAX: (312) 603-9842 or Suburban Municipal District ________ located at _________________________________________________ For Mediation ISSUE(S): Conciliation Reconciliation Emergency Intervention Nature of Emergency: ______________________________________________________________________ __________________________________________________________________________________ _________________________________________________________________________________ Please check if applicable: FOCUS ON CHILDREN IS A PRECONDITION TO MEDIATION. The parties and their attorneys are ordered to contact MFCS immediately when Emergency Intervention has been ordered. 4572 Office of Adoption and Child Custody Advocacy; George W. Dunne Building, 69 W. Washington, Suite 818, Chicago, IL 60602; Telephone: (312) 603-0550; Fax: (312) 603-9909 (contact Social Services Coordinator) For General Study Specific Study Other ISSUE(S): __________________________________________________________________________________ _________________________________________________________________________________ (Page 1 of 3) (Rev. 8/18/12) CCDR 0009 B 4617 Forensic Clinical Services Department (FCSD); George W. Dunne Building, 69 W. Washington, Suite 1000, Chicago, IL 60602; Telephone: (312) 603-1584 FAX: (312) 603-9842 (contact Administrator-Domestic Relations Program) ISSUE(S): __________________________________________________________________________________ _________________________________________________________________________________ 604(b) Evaluation 4621 Private resources for Mediation 4618 604.5 Evaluation 4622 Other Evaluation 4623 Name: ________________________________________________________________________________________ Address: _______________________________________________________________________________________ Telephone and Contact: _________________________________________________________________________ Costs shall be paid by: ___________________________________________________________________________ ISSUE(S): __________________________________________________________________________________ _________________________________________________________________________________ B. SPECIAL CONSIDERATIONS Pending DCFS Investigation C. Order of Protection Shelter Care Other Pending Proceedings Identification of Parties, Children, Attorneys Child(ren)'s Full Name(s) Age Date of Birth Residential Address ___________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Petitioner: Name: _________________________________________ * Address: _______________________________________ Petitioner's Attorney: Name: _____________________________________ Address: ___________________________________ ______________________________________________ Date of Birth: ___________________________________ Tel. No:(H) _____________________________________ (W) ___________________________________________ _________________________________________ Tel. No: ____________________________________ Fax:_____________________________________ Respondent: Name: _________________________________________ * Address: _______________________________________ Respondent's Attorney: Name: _____________________________________ Address: _______________________________________________ Date of Birth: ___________________________________ Tel. No:(H) _____________________________________ (W) ___________________________________________ __________________________________ ________________________________________ Tel. No: ____________________________________ Fax:_____________________________________ (Page 2 of 3) (Rev. 8/18/12) CCDR 0009 C Other: Name: _________________________________________ *Address: _______________________________________ Attorney: Name: _______________________________________ Address: _____________________________________ ______________________________________________ Date of Birth: ___________________________________ Tel. No:(H) _____________________________________ (W) ___________________________________________ ___________________________________________ Tel. No: ______________________________________ Fax:_______________________________________ Child's Representative/Guardian Ad Litem/Attorney for Child Name: _________________________________________ Address: _______________________________________ Telephone: _____________________________________ Fax: __________________________________________ D. 4574 Unless otherwise provided by court order, all Forensic Clinical Services Department (FCSD) evaluations, Office of Adoption and Child Custody Advocacy reports and reports or evaluations for Private Resources shall be in writing and sent to the Court and all
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