Doc Code: ______
FAMILY LAW COURT ORDER/MEDIATION AGREEMENT FOR SOBERLINK MONITORING
It is agreed/ordered that ______(Monitored Client) will participate in Soberlink Monitoring under the following conditions with a start date of: ______
FAMILY LAW MONITORING PROGRAM (Choose One)
¨ LEVEL 1 – Parenting Time Only: Test times are managed by the Monitored Client and Concerned Party (Testing is agreed to 30 minutes prior to possession of children/child and directly after parenting time has ended)
¨ LEVEL 2 – Daily Testing: 7 days a week at agreed upon times
FILL IN TESTING TIMES BELOW: (Level 1 and Level 2)
· Fill in the first test of the day ______: 00AM and the last test of the day ______: 00PM
· Select the total number of scheduled tests per day (Choose One)
¨ 2 tests ¨ 3 tests ¨ 4 test
Note: Level 1 testing schedule is managed by the two parties according to the times agreed upon
HOW TESTING ACTIVITY IS REPORTED TO CONTACTS (Choose One)
¨ Basic – Emailed daily reports of the previous day’s testing (No Real-time Alerts)
¨ Plus – Emailed test results in real-time
¨ Premium – Text and emailed test results in real-time
Note: Level based pricing can be found at Soberlink.com. Monitored Client and/or Concerned Party can agree to upgrade plan at any time.
Who is responsible for the cost of the device & monthly monitoring? ¨ Monitored Client ¨ Concerned Party
Monitored Client: The parent who is required to submit tests using the Soberlink Device.
*Name: ______*Email: ______*Mobile #: ______
Concerned Party: The person who receives test results.
*Name: ______*Email: ______*Mobile #: ______
The above conditions are agreed upon by: (document not valid without signatures)
______
Concerned Party (Sign and Date) AND/OR
______
Monitored Client (Sign and Date) Judge & County (Sign and Date)
AGR-OMA-17-003