Accessible: Wayne-County-Domestic-Relations-Form-53.pdf

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Page 10 Page 10 In the Court of Common Pleas Domestic Relations Division Wayne County, Ohio ________________________ Case No.: _____________________ Plaintiff vs. Judge/Magistrate: ________________ REQUEST FOR REVIEW ________________________ OF EVALUATION Defendant I request the opportunity to review the court-appointed professional’s evaluation on the issues of custody and/or parenting time (“the evaluation”). I understand that the evaluation may contain sensitive material. Any reproduction beyond BRIEF/SUMMARY NOTES is not permitted. No reproduction may be made or given to another individual. No party shall share any information found in the evaluation with the minor children or with any other person who is not a party to the case. Attorneys are expected to use professional discretion in sharing information with clients. As an officer of the Court, an attorney of record or Guardian Ad Litem shall make no disclosure about the evaluation except as necessary to perform his/her professional duties. Any person who violates this provision can be found in contempt of court subject to being fined and/or jailed. The attorney of record, unrepresented party, and Guardian Ad Litem may receive a copy only of the recommendation portion of the evaluation and then only after reading the report in its entirety. The attorney, unrepresented party, or Guardian Ad Litem must legibly initial each page of the evaluation before the Court will provide a copy of the recommendation section. Print Name: _______________________ Signature: _________________________ Date: ____________________ Circle One: (1) Plaintiff; (2) Defendant; (3) Attorney for Plaintiff; (4) Attorney for Defendant; (5) Guardian Ad Litem; (6) Other (specify) _____________________