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Family Court Roster Submission
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Name
Please include your full name and any designations.
Business Name
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Address
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Email Address
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Phone Number
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Languages Spoken
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Education Credentials
Please list your degrees and certifications.
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Licensure
Board of Psychologist Examiners
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Areas in Which You Want to be Appointed
Parenting Coordinator
Evaluation: Comprehensive Family Evaluation (CFE)
Evaluation: Focused Assessment (FA)
Evaluation: Independent Psychological Evaluation (IPE)
Evaluation: Independent Medical Evaluation (IME)
Intervention: Therapeutic Interventionist (TI)
Intervention: Court Ordered Behavioral Intervention (COBI)
Forensic Home Study
Parenting Conference
Parenting Consultation
Supervised Visitation
