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About Us
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Contact

Services
About Us
- Company
- FAQs
Attorneys
- Information
- Referrals
New Clients
Contact

New Clients

Complete Intake Forms:

If this is your first time here, please complete and submit the intake form below. If you need more information before submitting this information, please send us your message here. A court order is required for visitation services. Upon completion of this form, you will be provided a link to our orientation scheduling page. Each parent must complete a separate orientation. These orientations are for adults only. A separate orientation will be scheduled for the child(ren).

"*" indicates required fields

Phone

This field is for validation purposes and should be left unchanged.

Visiting Parent's Last Name*

Today's Date*

Month

Day

Year

Name of the parent/party completing this form*

First Middle Initial Last

Are you:*

Custodial Party

Visiting Party

Service you are seeking:*

Exchanges only

Supervised Visitation

Therapeutic Supervised Visitation

Other Parent's Name*

Your Email*

Enter Email Confirm Email

Your Nickname

Your Address*

Street Address City State ZIP Code

Your Personal phone*

Business phone

Your Birth date*

Month

Day

Year

Languages spoken (Please click the "+" sign for additional entries)*

Your Employer*

Your Occupation*

Emergency contact(s) - A person who could be contacted on your behalf.*

Name

Phone

Relationship

Demographic Information

Your Marital Status*

Single

Married

Domestic Partnership

Separated

Divorced

Widowed

Your Race*

American Indian

Alaska Native

Asian

African American

Native Hawaiian

Pacific Islander

Caucasian

Other

Your Gender*

Male

Female

Your Ethnicity*

Hispanic

Non-Hispanic

Vehicle Information

Vehicle identification*

Year

Make/Model

Color

License Plate

Children Information

Length of time since visiting parent's last contact with child(ren)*

Weeks

Months

Years

The Names of the Child(ren) in this case (use a separate line for each child)*

Name

M/F

DOB

Diet/Medical/Allergies/Special Needs of the child(ren)*

Court Information

Court Case Number*

County*

Judge's Name*

Attorney Information

Name of Your Attorney*

Phone*

Guardian Ad Litem Information

GAL Appointed

Yes

If Yes, GAL Name

If Yes, GAL Phone

Additional Information

Has DHS been involved?*

Yes

Are they currently an involved party?*

Yes

If DHS Involved, Caseworker's Name

If DHS Involved, Caseworker's Phone

Are Criminal cases pending for visiting party?*

Yes

Are Criminal cases pending for custodial party?*

Yes

Do you have a Medical Marijuana card?*

Yes

Please load a copy of your ID here. If you are unable to upload your ID here, please provide a copy at your first in-person contact. Thank you.

Max. file size: 256 MB.

What do you think is important for us know about this case?

What are your safety concerns?

What do you think the other party will tell us about you?

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Still Have Questions?

We have put together some Frequently Asked Questions (FAQs) to give you information about how to get started. Simply click on the question to reveal the answer. And if you still have a question that you can’t find the answer to, please Contact Us here.

Learn More Here

Important Information

Contact Information

Facility: 6905 NW 122nd St, Oklahoma City, OK 73142

Mailing: 6905 NW 122nd St, Oklahoma City, OK 73142

Email: jtiller@thechildstime.com

Phone: 405-999-2606

Scheduled Visitation: Tue - Sun 10 am to 8 pm

Office Hours: Tue - Fri 4 pm to 8 pm

Intakes: By appointment only

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