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Your Name (required)

Your Email (required)

Your Cell Phone Number (required)

Are you married or cohabiting? For how long? (required)

Are you separated now or still thinking about it? (required)

What is your job AND how much do you earn? (required)

What is your spouse’s job AND how much do they earn? (required)

Do either of you own any part of a company? (required)

Do you own a home or do you rent? (required)

If you have children, how old are they? (required)

Do you communicate well about the children (or is there a lot of conflict)? (required)

Has anything happened so far, a letter from Counsel, meetings? (required)

Is there any domestic violence? (required)

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