8/8/2019 2002 March 8 --Judge Anderson - Safe Visit

1/5

TKuehne Family YMCA - YMCA Safe VISit

Satellite Office

2036NWT ay lo r T op ek a. K an 51 l$ 66608 (785)234-4677 Fa. (7BS) 234-5466

Facsimile

Date:

l '4uDlber of pages

FROM: S.re Visit-St.IT -CS'-f-6r

TO: ltWl~ tlbl~rA-JC/O _

PhoDe II ~~- ... ~~=_Fa x # M7zJ{? 5;-2

5

'.

.~. " .

NOllce

The info"",t ion recelvClll hcJeln f.tnlI:IldClllror 1hc of rho penon or ..,tily EDwhich il is eddl=iled. ")'OIl h.ve r=ivClll this commlDliclJioD In

8/8/2019 2002 March 8 --Judge Anderson - Safe Visit

2/5

8/8/2019 2002 March 8 --Judge Anderson - Safe Visit

3/5

Please notifY Safe Visil about the outcome of the Court hearing on 3-11.02 so slaffeRnplan accordingly.

Cc: Leonard Robinson, counsel for ClaudinecDon Hoffinan, counsel for Hal.

Safe Visil staff does norprovide evaluations of the families who use the program's

services 07make recommendations about future arrangements f0 7 parent/child contact.Staff records parent/child contact. However, observations have occurred in a structured

and protected setting. Therefore, care should be exercised in using obseniations to predict WISlJ{)ervisedcontact.

8/8/2019 2002 March 8 --Judge Anderson - Safe Visit

4/5

SIGNED CONSENT FOR RELEASEOF INFORMATION FROM THE

SAFE VISIT PROGRAMFebnwy 16, 2002

1.CI.udjM Dombrowskl, d< l hereby give my w rlne n lIIId sigped rd_ of llIlYaD d .uinfmmation rel1Ued to my part icipation in the Safe Visit Pl'lIgram In Topeka, KS.

Any lIIId al l iDformIItion, writ1al, elecll'Oillc or via telephone comJIIllIliC8lion ill expressly

8I1d ON LY given to the reUowlng:

Leonard RObIJIsDIl, Atblmey @ La w1605 SW 3.,0 Street

Topeka, KS 666110fIlce Plcme: 185-261-5063

N O O T H E R permission is given; to release any iDformation to any other person is

aulhoriz.ed.EIpcctaOy DO intDrIIIIIlion Is to be released to Hlury Mocm: CSOIlI of ShaWllee CoUIltyDistrict Court ServiI:CSOR any other CoIIrt Sc :rv iC e l i Officer U D 1el1 s s tale d exclusivei)' in asigned Court Otder by a Dhnrict CoIIrt JlIdge in Shawrme Collllly.

This Release of information nullslU1d voids B1Ipr io r s1gnod releases of infarmalion, aDd

lIIkes effect on drls dale: Febnlllry 16. 2002.

SiBJted,

~\c.-~'

Claudine Dombrowski DalD:Febnwy 16,2002

~

?Z5~. ~:Feb~16.2002

cc: Leonard Robinson

8/8/2019 2002 March 8 --Judge Anderson - Safe Visit

5/5

P.5/S

~oM- . u 0 4 ,ii'"O~

"'~ri~~~~~Ii

,.~~OS ..I .u ,. t

iii~.):..~Tr'," ,o l .I o

~ 'jP'tMtI 'KoIJ,~/d t

iiiliiliiilll.~t ~

~It~04'"'oft~fr/t'~~~

, ,' . .

. 3/ 8/ 2 2:64PMj , 011178623454ee.~ OILLON/TCI; Page 0

:_8.2002 3:01PM SFf'"EVISIT PROGRAM NO.674,

iiit'Y J I I d

~?~ld4~

sit? 'J ilt 1 '? 'J '~ ~ + to /. ~QI} t.-.t.I/,d

.~#"fl

.'~~ ~ .~~ 'W~lt1'J!l;

.~~~~~'1-u.,~It

. J .1 o ~~~t---, .J.Ii ~

--=--------_ .._~-..~.-.:-..~ . : 2:: :::a::::.-n!::: . ~-,~LS-__=

Created jus t ftJr yoU by m e.