Parent Coordinator Agreement Meg L. Sussman, Ph.D.153 Main St., Suite G-5Mount Kisco, NY 10549Email: meglsussman@gmail.comwww.megsussmanphd.com(914) 666-0069 November 28, 2023 Parent Coordinator Agreement I have entered into an agreement with Meg Sussman, Ph.D. and Name *have entered into an agreement with Meg Sussman, Ph.D. to serve as a Parent Coordinator regarding our child(ren) until such time as a decision is made to terminate by any or all of the parties, including Dr. Sussman. This agreement will serve as a binding contract.We have retained Dr. Sussman with the goal of maintaining joint legal custody of our child(ren) in accordance with our divorce agreement of(Divorce agreement date)If we are unable to agree on any major issue regarding the health, education, or welfare of our child(ren) we may utilize the services of Dr. Sussman. In the event both parties agree, or the Court orders it, Dr. Sussman will serve as a tiebreaker.The first appointment will be a joint meeting in which we establish parameters of how we will work together. Following that, each parent will meet with Dr. Sussman separately. Thereafter, any contact with Dr. Sussman will be made in a transparent manner. That is, any meetings, phone calls, or emails will be made so that the parent coordinator and each of the parties are aware of the communication. There shall be no private conversations between either parent with the parent coordinator, except in the case of an emergency. We understand that Dr. Sussman may wish to speak with collateral contacts and/or our children for purpose of resolving a specific issue.While parent coordination may be part of our settlement or Court appointed, we agree that Dr. Sussman will not be asked to be involved with the Court, including but not limited to writing reports, testifying, or speaking with attorneys, except if there is an AFC. We will not provide communications with Dr. Sussman to the Court. We also agree that we will not record any sessions.Upon termination of the parent coordinator agreement, all materials including any written or oral communications shall remain confidential and may not be used in any court proceedings.FeesAll time spent by Dr. Sussman, including but not limited to meetings with parents and children, review of materials, collateral conversations, and written communication shall be billed at $_____ per hour. A retainer of $______ shall be collected at the time of this agreement and replenished when the balance is below $500. Please be aware that Dr. Sussman will not be involved in decision making as regards who is responsible for fees. Twenty-four hours’ notice is required for cancellations, or you will be charged the full fee. You will receive a monthly statement detailing all charges. Any outstanding portion of the retainer will be reimbursed upon termination.I HAVE READ THE ABOVE STATEMENT IN ITS ENTIRETY AND UNDERSTAND THE CONTENT AND AGREE TO ITS TERMSElectronic Signature *Date Signed, Parent *By typing your name above, you are signing this form electronically.Electronic Signature Agreement *I agree.By checking the "I agree" box, above, you acknowledge and agree that your electronic signature is the legal equivalent of your handwritten signature for the purposes of this form. Privacy Policy | Terms of UseSubmit Form