At the Kids First Center, we believe that language matters. At the First Step program, you may recall being introduced to the term "Co-Parenting Partner" or "CPP" for short. In this questionnaire, these terms mean the person with whom you share children and who has been ordered to take this class with you.

Intensive Co-Parenting Education (ICOPE) Confidential Intake

According to our records, you (and your coparenting partner) have been ordered to attend the Kids First Intensive Co-Parenting Education (ICOPE) Program. This program is a nine-week group workshop designed to enhance the happiness and resilience of your child/ren by improving the stability and consistency of your coparenting relationship.

Being ordered to attend ICOPE is just the first step towards enrollment, and the Kids First Center reserves the right to deny entry into the program to anyone whose situation would not be a good match for the program as currently provided.

To begin the process please fill out this questionnaire to help us better understand your coparenting situation, and upload any requested documents. Once your responses have been received, we will contact you to book a brief phone screening with our Intake Coordinator. Please note: both the questionnaire below and the intake screening will require you to discuss sensitive topics such as domestic violence, drug and alcohol misuse, mental health, and court matters. This information is for our internal use only and is critical to ensuring that this program is the right resource for your family.

Important Note: This program meets for nine consecutive weeks. Attendance at all nine sessions is required and expected by both the court and the Kids First Center. If you have reason to believe that you will be unavailable for any session, you must inform Kids First during the intake process. Excused absences are rare. Failure to attend is reportable to the court.

First Name

Last Name

Address

Street Address

City

State

Country

Postal Code

Email *

Primary Phone *

What is your preferred name or nickname?

What are your preferred pronouns?

He, him, his

She, her, hers

They, them, theirs

Other

What issues are currently in dispute in your court matter (check all that apply):

Please describe your current court proceeding (check all that apply and upload copies of any interim/final orders at the end of this questionnaire):

Complaint for Parental Rights & Responsibilities (unmarried parents)

Complaint for Divorce

Motion to Modify/Enforce/for Contempt

Current Protection from Abuse Proceeding

Former Protection from Abuse Proceeding

Current Criminal Proceeding (related to coparent or child/ren)

Prior Criminal Proceeding (related to coparent or child/ren)

Other

Are any of the following individuals involved with your court proceeding? Please check all that apply:

Provide the names of the professionals you checked above:

Have you attended the four-hour introductory program, The "First Step" in the last two years?

Yes - within the last two years

Yes - more than two years ago

I am registered for an upcoming First Step class

Has the Department of Health and Human Services (DHHS) been involved with any of your children? If so, please briefly summarize the complaint, extent of the investigation, and outcome of this interaction. Please upload any formal letters of completed DHHS investigations or findings below.

Please briefly explain why you feel that the Court has ordered you and your coparent to attend this program and what you hope to accomplish through this nine week workshop:

Has substance misuse of alcohol or drugs been a source of conflict in your coparenting relationship? If so, please briefly describe your concerns.

Have diagnosed mental health issues, traumatic brain injuries, or medical conditions been a source of conflict in your coparenting relationship? If so, please briefly describe the issue and the impact it has had.

Are you currently in a romantic relationship/partnership? If so, please state your partner’s name, the length of the relationship, and detail any interactions they have had with your children to date.

Upload copy of Order(s) *

XLSX, XLS, CSV, PNG, PDF, DOCX, DOC, JPEG or JPG ( max 5 Files )

Upload Divorce/Parental Rights Order

PDF, DOCX, DOC, JPEG, JPG, PNG, XLSX, XLS or CSV ( max 5 Files )

Kids First presenters are lawyers, therapists, and social workers. To avoid conflicts with cases involving yourself, new partners or other family members, please indicate if any of the following individuals have worked with your family:

Captcha

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

By checking this box, I consent to receive marketing and promotional messages, including special offers, discounts, new product updates among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.