Fillable FORM 12.984(d): INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES (Florida)

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FORM 12.984(d): INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES (Florida)

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Instructions for Florida Family Law Rules of Procedure Form 12.984(d) Parenting Coordinator Request for Status
Conference (07/14)
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.984(d)
PARENTING COORDINATOR REQUEST FOR STATUS CONFERENCE
(07/14)
When should this form be used?
A person appointed as a parenting coordinator may request a status conference with the judge and
parties under Florida Family Law Rule of Procedure 12.742(l). This form is used when the parenting
coordinator is unable to adequately perform the duties in accordance with the court’s direction.
This form should be typed or printed in black ink.
What should I do next?
After completing and signing this form, you must file the original with the clerk of the circuit court in the
county in which the action is pending, provide a copy to the presiding judge, and keep a copy for your
records.
You must mail or hand-deliver a copy of this form to the attorney(s) for the parents or, if not
represented by an attorney, to the parents.
Where can I look for more information?
Before proceeding, you should read “General Information for Self-Represented Litigants” found at the
beginning of these forms. For more information, see section 61.125, Florida Statutes; Florida Family
Law Rules of Procedure 12.742; Rules for Qualified and Court Appointed Parenting Coordinators; and
the Order of Referral to Parenting Coordinator, Florida Family Law Rules of Procedure Form 12.984(a).
Special notes
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out
these forms, that person must give you a copy of Disclosure from Nonlawyer, Florida Family Law Rules
of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms
also must put his or her name, address, and telephone number on the bottom of the last page of every
form he or she helps you complete.
Florida Family Law Rules of Procedure Form 12.984(d) Parenting Coordinator Request for Status Conference
(07/14)
IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT,
IN AND FOR ______________________________ COUNTY, FLORIDA
Case No: ________________________
Division: ________________________
_________________________________,
Petitioner,
and
_________________________________,
Respondent.
PARENTING COORDINATOR REQUEST FOR STATUS CONFERENCE
The undersigned Parenting Coordinator requests a status conference in this case:
(choose all that apply)
1. _____ To request direction from the court concerning _____________________________________
____________________________________________________________________________.
2. _____ To request resolution by the court regarding _______________________________________
___________________________________________________________________________.
3. _____ To report ____ petitioner’s____ respondent’s noncompliance with the Order of Referral to
Parenting Coordinator, orders for psychological evaluation, counseling ordered by the court
or recommended by a health care provider, or for substance abuse testing or treatment.
4. _____ To report that the case is no longer appropriate for parenting coordination.
5. _____ To report that the undersigned parenting coordinator is not qualified to address or resolve
certain issues in this case and a more qualified successor parenting coordinator should be
appointed.
6. _____ The undersigned parenting coordinator is unable or unwilling to continue to serve and a
successor parenting coordinator should be appointed.
Florida Family Law Rules of Procedure Form 12.984(d) Parenting Coordinator Request for Status Conference
(07/14)
WHEREFORE, the undersigned Parenting Coordinator requests that a Status Conference be set
by the Court.
_____________________ _________________________________________________
Date Signature of Parenting Coordinator
Printed Name: ____________________________________
Address: _________________________________________
City, State, Zip: ____________________________________
Telephone Number: _______________________________
E-mail: __________________________________________
Professional License # (if applicable) ___________________
Professional Certification # (if applicable) _______________
Copies to:
_____ Presiding Judge
_____ Petitioner
_____ Attorney for Petitioner
_____ Respondent
_____ Attorney for Respondent
_____ Other: ____________________________________________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:
[fill in all blanks] This form was completed with the assistance of:
{name of individual} __________________________________________________________________,
{name of business} ____________________________________________________________________,
{address} ____________________________________________________________________________,
{city} __________________________,{state} ______________,{telephone number} ________________.
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FORM 12.984(d): INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES (Florida)

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Completed 10 January 2021

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