Free Simple Case Note Template

Simple Case Note


Client Name: Jane Doe
Date of Contact: August 12, 2050
Case Number: 123456
Contact Method: In-Person


  1. Summary of the Case:

    Jane Doe approached [YOUR COMPANY NAME] seeking assistance with a family law matter regarding child custody. The primary concern is establishing a fair custody arrangement that prioritizes the well-being of her two children, ages 8 and 10. The case involves a contested custody battle with the children's father, John Doe, who has a history of inconsistent visitation.

  1. Client’s Background:

    Jane Doe is a 35-year-old nurse residing in [YOUR COMPANY ADDRESS]. She has been the primary caregiver for the children since the separation three years ago. Her work schedule is flexible, allowing her to be actively involved in her children's daily routines.

  1. Presenting Issues:

    • Custody Dispute: Jane is seeking full custody of the children due to concerns about their father's ability to provide a stable environment.

    • Communication Breakdown: There has been minimal communication between Jane and John, leading to confusion and conflict over visitation schedules.

    • Emotional Impact on Children: The ongoing dispute has caused stress and anxiety for the children, affecting their school performance and emotional well-being.

  1. Goals and Objectives:

    • Short-Term: Establish a temporary custody agreement that ensures the children's safety and stability.

    • Long-Term: Obtain full legal custody while arranging reasonable visitation for the father, ensuring the children's best interests are met.

  2. Action Plan:

    • Immediate Steps:

      • Gather documentation supporting Jane's primary caregiver role.

      • Arrange for a mediator to facilitate communication between both parties.

    • Next Steps:

      • Prepare for a court hearing, including collecting evidence and witness statements.

      • Explore the possibility of involving a child psychologist to assess the emotional impact on the children.

  3. Follow-Up:

    • Next Appointment: August 19, 2050, at 2:00 PM

    • Tasks for the Client:

      • Provide school records and any communication records with John Doe.

      • Complete a financial affidavit to assess child support requirements.

    • Tasks for the Case Manager:

      • Contact the mediator to schedule a session.

      • Begin drafting legal documents for the upcoming court hearing.

  1. Case Manager’s Notes:

    The client appears committed to resolving the custody issue in a manner that is in the best interest of the children. Jane has shown resilience despite the emotional toll of the ongoing dispute. Continued support and clear communication will be essential as the case progresses.


Case Manager: [YOUR NAME]
Date of Note: August 12, 2050

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