Informed Consent and Agreement for 3111 Child Custody Evaluation

Milton Kalish, L.C.S.W.

Mediation Child Custody Evaluation Psychotherapy

Licensed Clinical Social Worker #11335, Child Custody Recommending Counselor 

613 G Street, Suite A, Davis CA 95616 phone 

(530) 753-1331 fax 888-974-5784

Informed Consent and Agreement for 3111 Child Custody Evaluation

Thank you for contacting me regarding your 3111 Child Custody Evaluation. This contract explains my procedures for evaluations referred by the court.

I believe that it is in a family’s best interests to develop their own post-divorce parenting arrangements whenever possible. I become part of the process when a family's own attempts to resolve these issues, via mediation or conferences with their attorneys, has reached an impasse. When that occurs, or when the Judge orders a Child Custody Evaluation, I am asked to assist the Judge in determining the parenting plan which is in your child/ren's best interests. It is my belief, and research shows, that it is best for children when parents can agree on parenting arrangements, and my evaluations are designed to promote resolution of conflicts in this area.

Evaluation Procedures

In order to do a thorough evaluation, I will need to know information about each of you. I will be asking you to fill out a comprehensive form regarding yourself, your perceptions of the other parent, and your children. The evaluation includes appointments with both parents, your children, and perhaps others who play a significant role in your children's lives. The interviews may be individual and/or in any combination and as often as necessary for the purpose of the evaluation. I might also do home visits. In general, I do home visits when one or more of your children is under the age of six, or there are specific issues which can only be answered via home observations. Pursuant to the Court Order appointing me as your evaluator, I will also ask you to sign an authorization form which provides me with access to medical, school, legal and other professional information, and to exchange necessary information with various professionals. All of these steps are designed to give me a comprehensive understanding of you and your family.

During the evaluation, it is common for parents to ask me for advice or to give interim recommendations. I cannot do so because until I have completed the evaluation, I will not have all of the data regarding your family. On occasion I might give a brief, limited, short-term recommendation and then evaluate your ability to follow through, or to assess its impact on the children.

I like to inform parents that you are unlikely to know what I am thinking during the course of the evaluation. This is to discourage parents from reading into my questions, which are only designed to give me information, but not to give parents a sense of what I am likely to recommend. While I generally give no clue on my recommendations, I try to explain why I believe they are in your child’s best interests when the evaluation is over.

Collateral Sources

Many parents ask about my policy regarding collateral contacts. I will generally contact professionals with whom you have worked and who can give me necessary information about you or your children. Generally, these collateral sources might include teachers, child care providers, law enforcement officers, medical doctors, and therapists. I may also include others as well. If you have been ordered to participate in drug testing or anger management, I will contact those sources. It is rare for me to interview all collateral parties that are suggested. I usually phone only those professional collateral sources who I believe will add information to my evaluation. If you have one or two collateral sources that you believe are crucial to my evaluation, please let me know. Please note that I will inform sources that the content of interviews may be included in my report, and I may be required to testify about these contacts in Court.

Due to recent changes in case law, in the event that information obtained from collateral sources and documents is critical to the outcome of the evaluation, you may need to subpoena such persons for testimony if your custody matter goes to trial after my report has been submitted to the Court.


Many parents ask about confidentiality in a child custody evaluation. Quite simply, within the process, there is no confidentiality. I may share information that one parent tells me with the other parents, or ask one of you questions about what I hear from a parent, child, or any collateral source. The reason there is no confidentiality within the evaluation is to protect your due process rights and to ensure that I can clarify all issues and gather necessary information for my evaluation and recommendations. In addition, it is understood that I will be providing the Court, Family Court Services, and the attorneys with a comprehensive written report concerning the evaluation and my recommendations.

I may ask your children about things that I hear from either of you. I will inform your children that their statements may not be confidential, though I may inform you, your attorneys, and the Court if it believes it is in your child’s interest to protect that confidentiality.

Concerning information sent via digital technology, I take precautions to protect the confidentiality of all such communications, but there is no guarantee. Often some of the interviews are conducted via Zoom or the like. If this is a concern, the evaluation can be conducted through in person interviews, postal mail and telephone calls.

Please note that California state law requires reporting to the appropriate agencies in cases where there is a reasonable suspicion of child abuse, elder abuse, stated intention to injure yourself or another person, or inability to care for yoursel

Submission of Documents

I require that attorneys and parents send two hardcopies of any documents and other materials that they think will be useful. These should be received by me no later than four weeks from the date when this agreement has been signed by both parties. I do not accept documents sent by email without prior agreement.

Please note that the court appointment requires that copies of any materials sent to me must also be provided to the other parent or their attorney, and must be accompanied by a Proof of Service Form or Proof of Electronic Service Form. Please do not submit any original documents, and please note that I do not make copies of these materials for the attorneys or parties.


My hourly fee for conducting the evaluation is $220.00 per hour, which includes all interview time, home visits (if any), time spent phoning parents and collateral sources and/or reviewing written materials, reviewing parenting inventories, writing the report, and any other time spent in association with the evaluation.

Fees for all unpaid services to date are billed prior to each interview or whenever the balance due exceeds $850.00. These fees are payable in advance or at time of service. In the event that full payment is not received, the evaluation process will be halted and will not be continued until all fees are paid. The percentage of the fee paid by each parent is determined by your Court Order. Payment must be made by cash, check, or credit card. For credit card payments, I will add the processing fee of 3.5% (my cost).

My fee does not include court appearances or depositions. If either party wishes me to testify, I require a subpoena for court testimony or deposition, which must be received by me at least 2 weeks in advance of the date of testimony or deposition, along with the fee, paid in full. My fee for court testimony or deposition is $1000 for afternoon testimony and $1900 for morning testimony. All fees are the responsibility of the party issuing a subpoena. These fees include my 1/2 hour of driving time one way, and up to 2 hours of preparation. Fees for copying records are not included. Copying records can be efficiently accomplished by a forensic copying service, at your expense. If I must hand copy documents, the fee is $1.25/page. My evaluation fee does include being available on phone standby for Court Recommendation Conferences, provided that I can arrange to make the time available.

At least 48 hours notice is required to cancel or reschedule an appointment without being charged. Without 48 hours notice, the parent who misses the appointment will be billed for the missed appointment at full fee. If both parents miss a joint appointment, each will be billed for half of the fee. Excessive missed appointments can result in termination of the evaluation with notification to the Court of what portion of the evaluation has been completed.


I require a retainer of $2500.00 per parent, or $5000.00 if one parent is responsible for all costs, payable in advance of the first meeting. In most cases, the retainer covers the cost of writing the final report itself, but not the cost of interviews, review of documents, and collateral contacts, which are billed as the evaluation progresses. My goal is to be both thorough and cost effective.


On my custody evaluation form, I will ask each of you how you would suggest settling your dispute with the other parent. It is possible that I might agree with you when I have completed my evaluation, or I may disagree with you and recommend something closer to what the other parent wants. Please be aware that whatever I recommend, it will always be based on my analysis of all of the evaluation data and what I believe to be in your children’s best interests.

At the end of the evaluation process, I will offer an optional appointment to meet with both parents, in order to share the findings of my evaluation and my recommendations to the Court with both parents. The purpose of this session is to share and explain my observations and recommendations so that you can understand them and hopefully find a way to settle your conflicts. I do not meet individually with parents to share this information prior to the report being sent. After that meeting I will then send in my written report to the Court, and to the Attorneys.

Settlement Prior to Conclusion or Early Termination of Evaluation

If at any time during the course of the evaluation parents settle their custody or visitation dispute on their own, or jointly agree with the Court’s consent to the early termination of the evaluation, it will be discontinued and the Court will be notified. If I have been paid a fee that exceeds the time I have spent, I will refund any amount due at the end of the month following my receipt of a written statement that the evaluation has been halted. If at any point in the future either parent wishes to resume the evaluation process, a new evaluation will need to be ordered and new fees will need to be paid.

Agreement and Informed Consent

By my signature below, I acknowledge that I have read and understand all of the terms of this contract, and agree to abide by it. I understand that Milton Kalish LCSW is an independent practitioner, and that this contract is only with him, not any other entity or any other individual. I authorize Mr. Kalish to complete the evaluation and to provide recommendations to the Court.


Print name: ________________________________________


Print name: ________________________________________

613 G Street, Suite A, Davis CA 95616 phone (530) 753-1331 fax 888-974-5784 Licensed Clinical Social Worker #11335, Child Custody Recommending Counselor