FOR GUARDIAN AD LITEM SERVICES
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: _________________________________________
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.
1. I _______________________________
agree to participate with the G.A.L. for the purposes designated for his services by the
(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
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
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
6. I acknowledge that Mr. Carr will use his discretion in selecting
which records he will review and which collaterals he will
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_.
Thomas F. Carr, M.A., LMFT, LMHC
9 Kinsman Place
Natick, MA 01760-2732
Telephone (508) 650-1811
Fax (508) 650-3621