Welcome to CourtLink Monitoring Services
Please complete the intake form below before your first supervised visit or monitored exchange. Once your form is submitted, our team will review it and contact you within 1–2 business days to confirm your appointment and next steps.

CourtLink Monitoring Services – Client Intake Form

This information will remain confidential and will only be used for the purpose of providing supervised visitation or monitored exchange services.

If you have questions while completing this form, please contact us at sharon@courtlinkmonitoringservices.com or (818) 949-835

Contact & Case information

Contact & Case Information First & Last Name Address Email* Phone* Signature (Full Name)* Date Signed* Birthday (Month / Day / Year)

Phone

Birthday

Month

Day

Year

Attorney Information* Please provide your attorney’s name, law firm (if applicable), phone number, and email address. If you do not have an attorney, write “N/A.”

Client & Case Information* Please provide your full name, date of birth, gender, mailing address, email address, primary phone number, alternate phone number, case number, court name & location, and judge’s name.

Visitation Participant Information* Please list the names of all minor children involved, their dates of birth, your relationship to each child, custodial parent/guardian name and contact information, and non-custodial parent name and contact

Scheduling & Preferences: Please list your preferred start date, preferred visitation days/times, requested visitation location (public location, CLMS-approved facility, or other), and transportation arrangements.

Emergency & Medical Information* Please provide the names, relationships, and phone numbers of at least two emergency contacts. Include any medical conditions, allergies, medications, and special instructions for medical or safety concerns for you or the

Agreements * By checking this box, I confirm the following: ✅ I acknowledge that all information provided is true and correct to the best of my knowledge. ✅ I agree to comply with the visitation rules and guidelines set forth by CourtLink Monitor

Signature (Full Name) Date Signed

✅ I acknowledge that I have read and agree to the CLMS Agreement & Consent Guidelines.