PFC-66 E02-14
MANDATORY
FCS Support Person Participation Form
Family Court Services
Support Person Participation Form
Support Person Please Complete The Following
Date:
Case Name:
Your Name:
Relationship
to Party:
Mediation and Child Custody Recommending Counseling (CCRC) sessions are designed to effect a
settlement of the issue of visitation rights of all parties that is in the best interest of the children. You
are being admitted to this session as a support person to further facilitate this process.
Per the Family Code §6303, if a court has issued a protective order, a support person shall be
permitted to accompany a party protected by the order during any mediation orientation or mediation
session, including separate mediation sessions. However, Family Code §6303 also states that the
mediator may exclude a support person from the session for any of the following reasons:
If the support person participates in the mediation session
If the support person acts as an advocate
If the presence of a particular support person is disruptive or disrupts the process of mediation
Please note that Mediation and CCRC sessions are confidential and as a support person you are
bound by the confidentiality of the session. The mediator will not be available to any support person for
any direct contact or conversations about the family and/or the session. In addition, you may not
discuss any of the information shared during the session with anyone else outside of the
session. If you feel that it may be difficult for you to remain neutral or for you to maintain the
confidentiality of the information you hear during the session, please excuse yourself from the process.
Thank you for your support and cooperation.
Your signature indicates an understanding of these guidelines.
Signature:
Date:
/S/