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All the undersigned agree to the following terms and conditions for Thomas F. Carr, M.A., LMHC, LMFT to serve as the Court-appointed Guardian Ad Litem in the following matter:

    Case Name: _________________________________________
    Court _______________________________________________

    Judge _______________________________________________

    Docket No.:_________________________________________

    Citation of statue under which I have been appointed and recitation of             conditions, if any, described in the Court Order or  Stipulation appointing me .
    (this must be attached to the agreement; i.e. court order/appointment/stipulation)

1.       I _______________________________ agree to participate  with the G.A.L.   for the purposes designated  for his services by the Court .
    (a) evaluation
    (b) investigation
    (c) monitoring
    (d) visitation
    (e) other ______________________________

2.      I am aware that Mr. Carr may /will  be called upon to write a report upon the completion of his work or for trial, and that report will be             submitted to the ____________________ Probate and Family Court,            where it will be impounded.  My Attorney will have access to the                 report.  I may or may not be permitted to read the report.  I may not        
have a copy of the report.  If I am representing myself, I need the                 Court's permission to read the report or get a copy of the report.

3.      I understand that everything I say and everything that collateral               contacts say may be included in Mr. Carr's report at his discretion.              Nothing I tell him can be confidential.  The therapist-client privilege does     NOT apply to communications with Mr. Carr in his role as                 Guardian Ad Litem.  Mr. Carr will, where appropriate, review                 pleadings, medical records, school records, Department of Social                 Services records, and other written materials.

4.       I give Mr. Carr permission to speak with anyone he needs to in order to carry out his responsibilities as Guardian Ad Litem, including but not limited to; my individual therapist(s), marriage counselor(s), physicians, school personnel, DSS personnel, police and other public safety officers, court personnel, family members, neighbors, friends, and other people whose names I may submit to   Mr. Carr voluntarily or at his request.

5.       Where releases of information are required, I agree to sign such releases.

6.       I acknowledge that Mr. Carr will use his discretion in selecting which     records he will review and which collaterals he will contact.

7.       Mr. Carr's fee is billed at the rate of  one hundred dollars [$100.00] per hour (Unless otherwise stated here and initialed $________________) .  I agree to pay a retainer of seven-hundred  $700.00.   I understand that the hourly fee includes time spent reading documents, interviewing people in person and over the phone, correspondence, Court appearances, travel time, and report writing.  Out-of-pocket expenses will be documented and deducted from the retainer.

8.          A statement will be provided by Mr. Carr monthly, showing the time    spent, activity billed for, and out-of-pocket expenses deducted.

9.          When the evaluation or investigation is done (or Mr. Carr has otherwise  completed his work or withdrawn from the case)  and the report has been  submitted to the Court, if the retainer has not been used up, the remainder will  be returned in accordance with the payment formula ordered by the Court.  If the retainer was not sufficient, the additional amount owed will be paid within thirty (30) days, again in accordance with the payment formula ordered by the Court  If the Commonwealth is paying Mr. Carr, then you may not have any financial responsibility, unless the Court orders otherwise.

10.      Notwithstanding, the payment arrangement for conducting the              evaluation or investigation and writing the report Or other task outlined at the   time he is engaged) , if Mr. Carr is deposed, the party deposing him shall pay   him a retainer in advance of the deposition representing ten (10) hours at his     usual hourly rate.

11.      Mr. Carr will be compensated for the time he spends preparing for the  deposition, for time at the deposition, travel to and from the deposition,  and for reviewing the deposition transcript.  If Mr. Carr determines that he needs   an attorney to represent him at the deposition, the party who is deposing Mr.   Carr will be responsible for paying his attorney's fees as well.  If the retainer is  insufficient, Mr. Carr will submit an itemized bill which will be paid in full within thirty (30) days.

12.       Mr. Carr will be paid for preparation time, travel to and from Court, time in  Court if called by either party, which will be reimbursed at his usual hourly  rate,  by the party which calls him to testify, unless the parties agree or the Court orders a different payment formula .
13.      We agree to make every good faith effort to resolve any dispute which may arise.  If the dispute cannot be resolved and it     becomes necessary to institute  collection proceedings or file a complaint for contempt to recover unpaid fees,   the prevailing party shall be entitled to reasonable counsel fees, Court costs,  and expert witness fees.

    All the undersigned have read the Retainer for Guardian Ad Litem Services Agreement.  By signing this Agreement, each party acknowledges reading it, agrees that the terms are fair and reasonable, and agree to be bound by all its terms and conditions.

    Signed the ______ day of ______________, 200_.

___________________________            _________________________
(Party)                                                       (Party's Counsel)
Address:                                                       Address:

Phone:                                                           Phone:

___________________________            _________________________
(Party)                                                       (Party's Counsel)
Address:                                                       Address:

Phone:                                                           Phone:

Thomas F. Carr, M.A., LMFT, LMHC
9 Kinsman Place
Natick, MA  01760-2732
Telephone (508) 650-1811
Fax (508) 650-3621