CHILD CUSTODY QUESTIONAIRE / INTERROGATORIES

BRIEF BACKGROUND AND HISTORY

1.

When did you meet the other party in this matter?

What was the length of your courtship?

When did you marry, begin living together or commence a sexual relationship with this
person?

What were the circumstances surrounding the marriage/relationship?

What attracted you to him/her?

The age of the parties at the time of the commencement of this relationship:
Man: _____ Woman: _____

Describe your family history: (your mother, father, siblings, alcoholism or drug usage, abuse,
stars, black sheep)

Describe the family history of your (former) mate:

How did the children come about? (planned, unplanned, etc.)

Children's names and birth dates: (Names, Birth dates, Grades, Schoolteacher's names)

Children of prior marriages/relationships: (Names, Ages, with whom does the child(ren)
reside) Man: _____ Woman: _____

Describe the deterioration of the relationship:

MARITAL/COHABITATION HISTORY
1.

Date of marriage (or commencement of the sexual relationship or cohabitation, date

of separation/divorce).

2.

Who left the marital home? (circle one) Man Woman

3.

Who had the children at the time of separation? (circle one) Man Woman

4.

Who filed for divorce and when?

5.

If this is a paternity/custody action, please provide the appropriate history (suit filed,
blood tests, and acknowledgment of paternity)

6.

Were there other known relationships at the time of the divorce/separation? Man:
_____ Woman: _____

CHILD CUSTODY QUESTIONAIRE / INTERROGATORIES

7.

What was the date of the Judgment of Divorce (provide copy)?

8.

What has the arrangement (custody/visitation) been with the children (provide copies
of all custody/visitation/ support orders)?

9.

When was the last visit with the children by the non-custodial parent?

10.

If visitation has ceased, please provide explanation:

11.

Do you attend church? (circle one) Yes No

If yes, what is the name of the church?
What type of religion is this church?
How long have you been a member of this church?
Were there prior church affiliations during your marriage?
If so, what was the name of the church and how long were you a member with that church?
Do your children attend church with you? (circle one) Yes No
If yes, what activities are they involved in with the church?
How often do the children attend church?
With you?
With the other parent?

RESIDENCE HISTORY
12.

List all residences since separation/judgment of divorce: (Addresses, Dates Lived In,
and Reasons Moved) Man: _____ Woman: _____

13.

Who is residing in your home? (include adults and children in the home. Provide
names, ages, occupations and person's relationship to you)

14.

Describe your residence and explain why it is suitable housing for the children.

15.

Describe your spouse's/mate's residence and explain why it is not suitable housing
for the children.

16.

Have you remarried since the judgment of divorce? If so when and to whom?

17.

If not married, are you currently dating or involved in a relationship with someone
else? If so, please provide the name, address and phone number of this person.

18.

Please provide your former spouse/mate's current marital status or ongoing

relationships, if any:

MISCELLANEOUS INFORMATION

CHILD CUSTODY QUESTIONAIRE / INTERROGATORIES

19.

Do you have a history of alcohol/substance abuse or incidents of spousal

abuse/stalking, phone harassment charges? Yes No
If yes, list the dates of arrest(s), sentence(s) and treatment(s): (dates charged, sentences,
types/ places of treatment, dates completed)

20.

Please provide any other pertinent information as to the previous question (provide
copies of police reports, if possible)

21.

Does your (former) spouse/mate have a history of alcohol/substance abuse or

incidents of spousal abuse/stalking, phone harassment charges? Yes No
If yes, list the dates of arrest(s), sentence(s) and treatment(s): (dates charged, sentences,
types/places of treatment, dates completed)

22.

Please provide any other pertinent information as to the above question (provide
copies of police reports, If possible)
Have you ever been involved in counseling? If so, when, where, why and with whom? List
the counselor's name, agency and address:

23.

Has your (former) spouse/mate ever been involved in counseling? If so, when,
where, why and with whom? List the counselor's name, agency and address:

24.

Have any of the children even been involved in counseling?

If so, when, where, why and with whom?
List the counselor's name, agency and address:

25.

Do you feel that you have emotional problems?

Please describe.

26.

Do you feel that your (former) spouse has emotional problems?

Please describe.

27.

Do you have physical health problems?

If so, describe what conditions, how long have you had the condition, the treatment for the
condition, the name, address and phone number of the physician responsible for care of
this condition.

28.

Does your (former) spouse/mate have physical health problems?

If so, describe what conditions, how long he/she has had the condition, the treatment for
the condition, the name, address and phone number of the physician responsible for the
care of this condition.

CHILDREN

CHILD CUSTODY QUESTIONAIRE / INTERROGATORIES

29.

Please list each child living in the home (note their relationship to you) and briefly
describe:
a. The personality of each child.
b. The school activities and interests of each child.

30.

Do any of the children have special educational or emotional needs, that is, have
they been placed in a program through the schools to receive special services?
If so, describe the disability and the length of time they have received services. If possible,
provide the name and address (school) of the person providing the service or the name of
the school counselor or administrator

31.

How have you participated in the educational development of your child since the
separation and judgment of divorce?
(Please be specific)

32.

Would there be a significant difference in the education opportunities offered by

either parent?
If so, describe with specifics.

33.

Do any of the Children have physical health problems?

If so, describe.

34.

How do you discipline your children?

What methods do you use?
Are they effective?

35.

How does your (former) spouse/mate discipline your children?

What methods does he/she use?
Are they effective?

36.

List each child individually and list the most difficult behavior for you to handle?

37.

What are your faults or weaknesses as they pertain to the children?

38.

What are your strengths as they pertain to the children?

39.

Is the children's medical care current? Yes No

If no, please explain.

40.

Does either parent object to medical care in general?

41.

Which parent has been most involved in obtaining medical care for the children?

CHILD CUSTODY QUESTIONAIRE / INTERROGATORIES

42.

Has there ever been any complaint registered that the children have no t received
the necessary or needed medical care? Yes No
If yes, please explain:

43.

Has child protective services ever been contacted regarding the care/control of your
children? Yes No
If yes, describe when, who and why and the disposition of each incident?

44.

What is the most rewarding thing for you as a parent in parenting each child?

45.

In your opinion, what are the most important lessons you want your children to learn
in life?
How are you teaching them this lesson?

46.

Please describe your childcare plan or proposed childcare plan, Include the name
and address of the baby-sitter or day care center.

47.

Describe your relationship with your children:

48.

Describe the relationship of the other parent to your children:

49.

What are the changes in circumstances since the separation/judgment of divorce that
has lead to this change of custody petition?

50.

What have you told your children about the pending (change of) custody petition or
divorce?

51.

How do you discuss divorce/custody issues with the children?

52.

What are you hoping will be the outcome of this litigation?

53.

What type of involvement would you like your children to have with the other parent
and the relatives of the other parent?
How would you facilitate the relationship?
(Please describe with specifics.)

54.

What activities doe s the child share with each parent?

55.

What is each parent's perception of the children's attachment to all family members?

56.

What evidence do you offer to justify your perception?

57.

Do the children experience privileges with one parent that they do not with the other?

58.

Who do the children go to for attention, affection, and advice?

59.

Who initiates affection or interaction? How is it displayed?

CHILD CUSTODY QUESTIONAIRE / INTERROGATORIES

60.

Do the children demonstrate any conflicts of loyalty when with one parent?

61.

How does each parent demonstrate their love and affection for the children and how
consistent is it?

62.

Has either parent been abusive to the children? In what ways?

63.

What is the current environment with regard to housing, location, cleanliness,

household furnishings, play area, etc.?

64.

What is the pro posed environment?

65.

Are there influences in either home that might induce delinquent or criminal
associations? If so, please explain.

66.

Has the other parent attempted to remove or destroy the relationship between the
children and you? If so, please explain.

Please provide any other information pertaining to you, the child's other parent, and the other
children in the family/home that may have an impact on this case. Of great interest to the courts
in is the determination of the primary parent. The following is the Michigan Child Custody Act
(MC LA 722.23). It uses the following provisions to assist the Court in determining the best
interest of the minor child. (Your state may have some differences, and it is suggested that you
go to the local library to look them up. A reference librarian can help to locate the state statute
books.) Please provide information under each point as it pertains to both parties (good and
bad).
1.

The love, affections and other emotional ties existing between the parties and the
child.

2.

The capacity and disposition of the parties involved to give the child love, affection,
guidance, and continuation of the educating and raising of the child in its religion or creed, if
any.

3.

The capacity and disposition of the parties involved to provide the child with food,
clothing, medical care or other medical care recognized and permitted under the laws of
this State in place of medical care and other material needs.

4.

The length of time the child has lived in a stable, satisfactory environment, and the
desirability of maintaining continuity.

5.

The permanence, as a family unit, of the existing or proposed custodial home or

homes.

CHILD CUSTODY QUESTIONAIRE / INTERROGATORIES

6.

The moral fitness of the parties involved.

7.

The mental and physical health of the parties involved.

8.

The home, school and community record of the child.

9.

The reasonable preference of the child, if the Court deems the child to be of sufficient
age to express preference.

10.

The willingness and ability of each of the parents to facilitate and encourage a close
and continuing parent-child relationship between the child and the other parent.