WPC? 6`rFJF]pd)pbF( $u+>^j@=!énjbH$,gs55~,/`-X6` mLZi@%oҹh:D,WZvDSbBސkn0u讱3}JO48`7ƨ$*@DPGa\ mpB7Zp4^d~fZ6j*OB{,w KQw￴Gux>Bzur G['e]]w+eT㵫d53#+rW5Q?bZwyrPFZ%xg iQEņ.XSC!xsDƅM [29jW]U? j[ Bӿzo$ԃ,$3 Ac 3C/~(#Sj3pJ#ugvbh#U@W % 0(U:U@?wA4EYhNp^ r m~ 1 72 0bN 0v 0& 0 0N 0 0 0 0 1u 727HP LaserJet 4,,,,,,0)L  Z (CG Times RegularX($+L  "CG Times Bold(L  Z (CG Times Regularl',3|x}f, UhCEIMQUY]aAutoList1""""""""i)1)a)"(:y$2  "3  0  (Ns$0  2  "3  0` (#(#(b$0  0` (#(#2  "3  0 ` (#` (#(v{$0  0` (#(#0 ` (#` (#2  "3  0 (# (#(p$0  0` (#(#0 ` (#` (#0 (# (#2  "3  0h(#(#(ʦ$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2  "3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2  "3  0(#(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2  "3  0p(#(#(<$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#0p(#(#2  "3  0p(#p(#3#37=CIQYag1.a.i.(1)(a)(i)1)a)i)  !  _XXXXXX@ LawOfficeofStacyL.Ortega,P.A.  @LL#LandmarkSquare  @BB212NorthMarket,Suite306 0 @ll Wichita,Kansas67202 H @Telephone(316)2635900  ` uXEXu@*   DISPUTERESOLUTIONSERVICESPAYMENTPOLICY  0    Parents:Pleasereadthis,signit,andreturnitbeforeyourfirstappointment.Thesefee `  policiesapplytoallvoluntaryandCourtordereddisputeresolutioncasesincludingmediation P  anddisputeresolutioncounseling. Youwillbeexpectedtopay$300inadvanceofyourfirst @  appointment.  0    SchedulingAppointments:    *   Initialappointmentsarescheduledbythemediatorsoffice.Thetimeisselectedbya  neutralstaffpersoninmostcasesandisnotnegotiable.Mostparentsrequestthatappointments  bescheduledoutsideoftheirworkschedules.Duetoalimitednumberofavailableevening  appointments,theinitialsessionissetduringregularbusinesshours,generallybetweenthe p hoursof8:30a.m.and5:00p.m.,MondaythroughFriday. `  *   Cancellationsmustbemadebybothpartiesinthedisputeatleast24hoursinadvance. @  *   Eachpartyinthecaseispersonallyresponsibleforacancellationandwillbecharged  p thefullfeeforthetimeifthecancellationisnotmadeasdescribedabove.Thispolicyalso ` appliestocancellationsbecauseofsettlementpriortomediation. P  Paymentoffees:  0  *   FeesaredividedequallybetweenthepartiesunlessaCourtorderspecifiesadifferent ! division.Chargesformediationanddisputeresolutioncounselingare$150/hour.Youwillbe " chargedforallworkperformedonyourcase. #   *   Mediationanddisputeresolutioncounselingserviceswillnotbeprovidedwithout % " initialfeepaymentfrombothparties.Feesareduepriortothefirstsessionandonthedateof p&!# serviceforsubsequentsessions.Agreementorimpassenoticesmaynotbereleasedwithoutfull `'"$ paymentoffees. P(#%  *   Reducedfeesareavailabletopartieswhoqualifybyincome.Incometaxreturnsand 0*%' currentpaystubsarerequiredasproofofincome.Pleasesendcopiesofthesametomyoffice  +p&( forconsiderationofthereducedfee.Onlythequalifyingparentwillreceivethebenefitsofthe ,`') reducedfee.The nonqualifyingparentwillbechargedthestandardrates. -P(*  -@)+  (x3*  Youwillbechargedforpostageandcopies.   *   Accountsinarrearsmaybesenttoacollectionagencyortoaprivateattorneyfor  action,andCourtmaygrantjudgments.    IhavereadtheabovepoliciesandIagreetopayallfeesincurred. `     `    _______________________________  _________ @     `    Signature     p     Date 0