Child Custody Investigations
Reference Questionnaire

Case Number

Name of Party for Whom You Are Completing the Questionnaire

Instructions: As you answer each question below, please keep in mind that it is the responsibility of the Court to safeguard the welfare and future development of the children in this family. You can help the Court in meeting this responsibility by being objective and confining your statements to observations which you have personally made. Answer each question as completely as possible. The investigator may contact you personally to discuss your statement with you. This questionnaire is to be completed immediately and returned to the Office of the Friend of the Court.

Your Name

Your Address

Phone Number (Home)

Phone (Work)

Ext.

Your Relationship to the Party Above (friend, employer, etc.)

How Long Have You Known the Party Above?

Date Last Seen (Party)

How Often Did You See Him/Her?

How Long Have You Known the Children in This Case?

Date Last Seen (Children)

How Often Did You See Them?

Do You Know the Other Party?YesNo

Comments

A) Physical Environment

If you have been in the home of the party for whom you are a reference, describe the home including housekeeping standard, who prepares meals, etc.:

B) Care of Children

Describe how the party for whom you are a reference treats the children (cleanliness, clothing, discipline, supervision):

What is the nature of the relationship between the party and the children from your observation?

Have you ever witnessed physical or emotional abuse of the children by either party (explain and give dates)?

C) Children

State your personal observations of each child, include any physical or emotional problems known to you:

Have the children expressed their feelings regarding custody/visitation to you?

D) Parents

To your knowledge, does the party for whom you are a reference have problems in any of the following areas?

If the answer to any of the above is yes, please give details:

E) Custody

Based on your observations, please state which party you feel should have custody and explain why:

Do you feel the party is unfit to have custody?YesNo

F) Additional Comments

Reference Signature

Date

Child Custody InvestigationsReference Questionnaire