Carolina 

Divorce Mediators, LLC

 

 

 

(704) 896-5882

Mediation Services for the Greater Charlotte, NC area

Convenient mediator offices at SouthPark and Lake Norman

 

 

Call 704-896-5882 for a free consultation

 

Click HERE for a free information packet

 

 
   
 
 

 

A "download and print" version of this form is available here.

 

When a marriage or a couple's relationship is coming to an end, the willingness to cooperate with the other party often does not come easily. Sometimes, one party is of the opinion that the other is responsible for the prevailing loss and accompanying pain. The situation is more difficult of resolution when the custody of children is an issue.

 

The purpose of this exercise is to assist you in realizing the extent to which you are ready to pursue the mediation process as a means of arranging how you are to spend your time with your children, and further, how you can best exercise your responsibilities. It is most important that you consider carefully your thinking and feelings about each item before responding.

 

The scale of 1 to 5 represents a range of thoughts and feelings. Number 1 indicates that you are not ready or have strong negative thoughts or feelings about the issue. Progressively up to number 5, your thoughts and feelings are less negative and less reluctant and a 5 indicates that you are quite positive about the item, that, in fact, you're ready and willing to discuss the matter toward a viable solution. 

 

 

1  2  3  4  5

Do I really want to resolve the issues before us equitably?

1  2  3  4  5

Am I willing to put aside my anger and deal with the issues in a rational manner?

1  2  3  4  5

Am I willing to make some compromises and let go of some of my hopes, fears and disappointments?

1  2  3  4  5

Do I value the importance of the child(ren)'s relationship with their other parent?

1  2  3  4  5

Am I willing to work towards our most constructive and fairest agreement?

1  2  3  4  5

In regards to parenting, am I willing to consider the child(ren)'s needs above my own?

1  2  3  4  5

Can I share the children and be separate from them when they are with the other parent?

1  2  3  4  5

Can I share control, authority and decision-making regarding the children?

1  2  3  4  5

Can I keep the children protected from my angry or hurt feelings and complaints about the other parent?

1  2  3  4  5

Am I openly supportive of the child(ren)'s relationship with their other parent?

1  2  3  4  5

Do I really believe that it is okay with me for them to have a full relationship with that parent?

1  2  3  4  5

Can I stick to the issues regarding the child(ren) when we must communicate about them?

1  2  3  4  5

Can I accept the differences that exist in the other parent's style of parenting?

1  2  3  4  5

Am I willing to work with the other parent to find a way to handle the fact that we have these differences?

1  2  3  4  5

Am I willing to have open and forthright communication with the other parent in order to communicate important events/information?

1  2  3  4  5

Am I willing that the child(ren) spend time, on an overnight basis, with their other parent?

1  2  3  4  5

Am I willing that the child(ren) spend time, on an overnight basis, with their other parent's parents (i.e., their grandparents)?

1  2  3  4  5

Can I accept the possibility that at some point in the future my child(ren) may well have a step- mother or stepfather?

1  2  3  4  5

Where I have indicated a 1 or 2 (negative) level of thoughts or feelings, am I prepared to discuss what my needs and interests are around that issue?

 

 

 

 
 
 
     
 
 

Call 704-896-5882 for a free consultation

Click HERE to request a free informational packet

Home - How it Works - Before Mediation - Children's Issues - Financial Issues - Resources - Client Center - About Us - Contact Us

Divorce Mediation Services for the Lake Norman and greater Charlotte, NC metropolitan area
Charlotte, North Carolina
Copyright 2013, Charlotte Mediation Group, LLC, Carolina Divorce Mediators, LLC,  All rights reserved