the undersigned, have entered into an agreement with Meg Sussman, Ph.D. to  serve as a family specialist as part of my divorce until such time as the divorce is finalized and/or the collaborative process is terminated. This agreement will serve as a binding contract.

I have entered this process, the goal of which is to help my spouse and me to work successfully to achieve a positive resolution that minimizes the negative social, economic, and emotional consequences that the family often experiences in a traditional adversarial process.

I have retained Dr. Sussman in the role of a family specialist. In this role, Dr. Sussman’s will work with my spouse and me to:

• Identify and prioritize the concerns of each person
• Make effective use of resolution skills.
• Work with the lawyers and other involved professionals to enhance communication and reduce misunderstandings.
• Direct our best efforts towards keeping the process moving forward toward resolution.

If there are children involved Dr. Sussman will also:

• Identify and prioritize the needs of our children.
• Give voice to the children’s thoughts and wishes in the Collaborative process.
• Help us talk to our children about our divorce and expectations for the future.
• Provide recommendations to the team regarding the co-parenting plan and other issues that concern the children.

Although Dr. Sussman is a licensed psychologist, she will be working with you in the role of family specialist, not a psychotherapist.

CONFIDENTIALITY

I agree to sign a confidentiality waiver for Dr. Sussman and the other members of the team to allow communication between us.  The specifics of this will be discussed before the confidentiality waivers are signed.

Should either party elect to terminate the collaborative process, all materials including any written or oral communications shall remain confidential and may not be used in any court proceedings.

I agree not to record any communication with Dr. Sussman. 

FEES

 All time spent by Dr. Sussman, including but not limited to: individual meetings, team meetings, review of materials, collateral conversations, and written communication shall be billed at $____ per hour. All team members maintain their own fee agreements and bill independently for their time.  After the initial meeting a retainer of $____is due by the first meeting. This retainer will be held throughout the collaborative process and will apply to any final services rendered, with the remainder of the retainer refunded within 10 working days of the termination of the collaborative process. Monthly statements will be sent with payment due upon receipt.

CANCELLATIONS

Twenty-four hours’ notice is required for cancellations. Because appointment times are reserved exclusively for you, you will be charged the full fee for a late cancellation or missed appointment.

I HAVE READ THE ABOVE STATEMENT IN ITS ENTIRETY AND UNDERSTAND THE CONTENT AND AGREE TO ITS TERMS.