Free Notice of Intent to Mediate - New Hampshire

Clear Form

THE STATE OF NEW HAMPSHIRE

JUDICIAL BRANCH

http://www.courts.state.nh.us

Court Name: Case Name: Case Number:
(if known)

NOTICE OF INTENT TO MEDIATE
Abuse/Neglect Minor guardianship Termination of Parental Rights

NOW COMES THE BIRTH PARENT(S) OR LEGAL PARENT(S), AND HEREBY STATE AS FOLLOWS: · I am currently involved in a case in which DCYF is a party. · I have agreed to engage in the process of voluntarily mediated adoption under RSA 170-B:14. · My agreement to participate in the mediation process shall not be construed as an agreement to the adoption of my child(ren) but merely an agreement to engage in the mediation process. · By signing this notice of intent to mediate, I am not waiving my right to contest the underlying claims against me nor am I waiving any right to contest the adoption of my child(ren) if the matter does not settle in mediation. · By signing this notice of my intent to mediate I am requesting only that the Court schedule the matter for mediation. · By signing this notice of intent to mediate I am consenting to have the prospective adoptive parents be considered parties to the mediation and to receive notice of when the mediation shall take place so they may attend the mediation session. · By signing this notice of intent to mediate I am agreeing to participate in the mediation in good faith.

Date

Birth Parent or Legal Parent

Counsel for Birth or Legal Parent

Date

Birth Parent or Legal Parent

Counsel for Birth or Legal Parent

So Ordered:
Date Signature of Judge

NHJB-2542-F (10/15/2008)

Top of Page