What is the Domestic Relations Screening Form for?

The Chatham County Office of Alternative Dispute Resolution uses it to screen domestic relations cases and assess whether mediation is appropriate, including safety concerns.

Who should complete this form?

The office recommends that each party complete their own form. It asks about communication, safety, and concerns related to mediation.

How do I submit the Domestic Relations Screening Form?

Complete it immediately and return it to the Chatham County Office of Alternative Dispute Resolution at 133 Montgomery Street, Room 503, Savannah, Georgia 31401. Do not file it in court.

Do I need a notary for the Domestic Relations Screening Form?

No. The form does not require notarization; the signer just signs and dates it.

Chatham County, GA · Chatham County

No notary required

Domestic Relations Screening Form

This form helps the Chatham County Office of Alternative Dispute Resolution screen domestic relations cases for suitability and safety concerns related to mediation.

At a glance

Issued by: City of Chatham County · Chatham County, Chatham County, Georgia
Notarization: Not required: file this form without a notary.
Official source: cccdn.blob.core.windows.net
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

The Chatham County Office of Alternative Dispute Resolution uses this form to screen domestic relations cases for whether mediation is appropriate. The form asks about communication, safety, domestic violence allegations, and concerns about participating in mediation. The office says each party should complete their own form and return it promptly; do not file it in court.

Who needs it

Each party in a domestic relations case being screened for mediation is recommended to complete and return a separate form.

How to submit it

Complete the form immediately and return it to the Chatham County Office of Alternative Dispute Resolution at the Chatham County Courthouse, 133 Montgomery Street, Room 503, Savannah, Georgia 31401. Do not file it in court.

About notarization

This document is signed and dated without a notary; the form asks for a date, and the signer just signs and dates it.

How to submit this form

1
Download the Form
Download the Domestic Relations Screening Form for your domestic relations case.
2
Complete the Questions
Provide your name, county, date, and case number, then answer the screening questions honestly.
3
Sign and Date
Sign and date the form. The document does not require notarization.
4
Return It to the ADR Office
Return the completed form to the Chatham County Office of Alternative Dispute Resolution at the courthouse address shown; do not file it in court.

Frequently asked questions

What is the Domestic Relations Screening Form for?: The Chatham County Office of Alternative Dispute Resolution uses it to screen domestic relations cases and assess whether mediation is appropriate, including safety concerns.
Who should complete this form?: The office recommends that each party complete their own form. It asks about communication, safety, and concerns related to mediation.
How do I submit the Domestic Relations Screening Form?: Complete it immediately and return it to the Chatham County Office of Alternative Dispute Resolution at 133 Montgomery Street, Room 503, Savannah, Georgia 31401. Do not file it in court.
Do I need a notary for the Domestic Relations Screening Form?: No. The form does not require notarization; the signer just signs and dates it.

Need something notarized?

This Domestic Relations Screening Form doesn’t need a notary, but if you have another Chatham County form that does, a commissioned online notary can help.