2010 Jan. 28 --Order for Parenting Time 28 Jan. 2010

8/7/2019 2010 Jan. 28 --Order for Parenting Time 28 Jan. 2010

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eoreFirst Blink&Trlllt Building100 E. 9'~Street - TlJird JI100r alitTopfta, Kan, 66613(785) 233-5187 Phollt(785)233-2173F.~

Fax

1 -/(lllm ~lll & H cd'V ' i Ll 11\ltnrnC\ ': : > el l I ~n\

T o :

Fax ;

R.E. Tuck DUDcan f rom; Donald R. Hoffinan

Pages: 6

Attn:

R e:

oUrgent

RidJardson v. Dombrowski

aFor Review

.DItc:

cc:

IJ P J e a . . 'l C Comment

February 2, 2010

o P lea se R ep ly [J Hard Copy to follow

Thi! facsimile contaios InformatWo that (a) i, or may be LEGALLY PRIVILEGED,

PROPRJETARV IN NI\TURE, OR OTHIRWISJ PROTECTJ:D BY LAW FROM DISCLOSUREand (b) ~ intended for the use of tile Addrcssee(lI) na.ed hereil'l. If you are not the intended

recipien~ 8ft addressee, or tile penon relJponsibJe for deli\'eriltg this to an addreuee, yoo arc hereby

notified tbat reading, copying or distrJ"butillg Otis faeshnlle is probibited. If you have rueived tbis

facsimile in error, please telephone us immediately and nnlil1he facsimile back to Ull at the address

above. Tunk you.

Additional comments:

Enl;loscd please f ind the executed Order Establishing PlU'CDtingTime and a bil ling statement 8Jldcontract with Hamilton & Wilson Orthodontics . She needs to beg in paying her share orthe encloseduninsured expenses.

Thank you for yom attention to the matter.

Cordially,

D O N A L D R . HO f f M A NAttorney at La w

If all pal" are not received, pleale can (785) 233-5887.


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.~

Raben E Duncan, IIA t lDme y a t Law, t0924Z2129N 8" Avenue . Suite 202T o p e k a . K S SS603(795)23~8S

IN THE DI STRICT COURT OF SHAWNEE COUNTY. KANSAS

Hal Richardson,

VI.Petitioner

CeseNo.980211

Claudine Dombrowski.Respondent

ORDER ESTABLISHING PARENTING JlME

NOW on this 28'" day of January. 2010, the above captioned metter came on for

hear1ng before the Cour t to establish parent ing time. Petitioner appears in person by

and through his counsel Jason P. Hoffman. Respondent appears in person by and

through her counsel Robeft E. Ounce" II. Jin Dykes, Guardian ad liIem appears. The

Court, having heard the statements of Counse'. having heaJd lhe statements of

Peti tioner, and being tufty apprised in the premises. FlNDS AS FOUOWS:

1. In acco"nce with K.SA. 6O-1618(a)"8 Respondent, \t>'her shall have

unsupetviaed parenting time on Sundays from 1:00 p.m. unlil 3:00 p.m. The exchange

shaU take p l ace at Ile T o p e k a Police Department

2. .Mother shaD have tw ice .weekIy phone contact from 8:00 p .m. to 9 : 00 p .m.

each Tuesday and Thursday.

3. The Respond_ MotherwiU be responsible for 0I1&-M1f (112) of the child's

Otthoclontics Petitioner is to provide bills for said services as per Shawnee County

guidel i r )e8:4. There will be a "",iew heartng on March 2, 2010 lit 8:30 am. to evatuate

the unsupervised parenting time.

_._-_...'-r.~.-,


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S. Prior orders regarding not uploading to the internet the child's image or referencesto said child remain full force and in effect.

6. Further Respondent is not to discuss this case or any matters regarding the facts

giving rise to these proceedings wi.th the minor child.

7. The G uardian ad Litml will visit with the child after each visit to assess progress.

IT IS THEREFORE, BY THE COU RT, CONSIDERED AND ORDERED THAT the

findings of the Court as set forth above, be and are hereby, the orders of this Court.

IT IS SO ORDERED.

runGE OF THE DISTRICT COURT

APPROVED BY:

Rober t E . Duncan II.##09242

Attorney for Petitioner

Jill Dykes

Guardian ad Litem


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Steven Uslmstran, D.D.S.

MIrk L Underwaod, O.D.S., M.e-d.

.~

Paul8~ghl, D.D.S.,P.A.

-_. . . . ~~--Optilllum orthodtmtic tWUftlf un '" KhieWJd with lnformtJd8111lCGli/itmltiwJptIt/IInts. Onhodontlt:treatment. bei", m MK:tiwt prtlCtldUffl,requiru undlm;ttlndirtlitif'the in""'t ~ INId'/tII'WIlll&.

'T 'hcr tsJi Isre e/dQm enoufhto.make trtMtmtlnr iMdvi6tIbI but"'wld b tl cOMidwrld.

F.cassidy, D.D~., P.A.,(D~Rsmilton, D.D.S., M.S.D P.A.

~ B. Edmonds, 0.0.$., M.S.

on Co Wlleon. O .D .8 . .

FACTORS THAT ARE DIFFICULT'TO PREDICT

-c l io

all TtRiIMnt Tooth Mowwment - All individuals, whether or not they have hId orthodontics, ani tubieCtto subtle dnt,.. in tooosition. especiallv in the late teens or twanties. After treaem,nt or retention. the passibility also 8adS1S for r01,lltionorcrowdinoOe hont teeth, or for spIICin, in extraction sites or betw.n the.fro'!t teetb." . . ..

. tIIIIClfOIftlllllllibulu JoinlPrabI (TMJ) - CTMJ) problems may develop with this joint and surrounding muscles Incllipmentl w

r without orthodontic tntltment. This eomplex stiding Joint. which allows for movaTlent of the lower jaw. em'be affec1lld by tooosition. bite. or preexiSting undeteCted factors. Tooth alignment-or bits correction Can improve tooth nsllusa'c:aus. of TMJ pai~'bot in an cues. T8n1ion appears to play a role In the frequency and severitY of joint pains. An equilibration (selective smoothingShtlping of the teeth) or other special trutmant may be recomm""dlld by vour dentisf 111Impro~athe joint rellItIonmip _ how t

8eth fittogether. .

oot RIIaIptDt - Shortening of root ends can occur when teeth 're moved during 0. d.odontic: trea1ment. Unct.r helithy conditionhe mortened roots Ily ere no problem. Trawna. imPBi:don. endocrine disCIrden or Idiopa1f1ic (unknown) ~ may _ is problem. SeYItI'8 resorption can increase1he posliblilty 0 ' premature tooth 'OSI. .

m TtItIa -In attempting 111move impacted teeth (teeth unable to etupt normally). especially CUlPids and third molars (wildoih), 'arious problem. Ire wametimes encountered which may lead to gum and bone probl , rei or'" o r teeth. .ll Grawth Pattams - Unusual skeletal patterns and i"sutrlCient or undersirable facial grDyIth cen I;OftIprami onhodoatisulu, effect a facial change and cause shifting of teeth during retsntion. Surgical asslstance-mav"barecammend-.d in th8$1I siUi8tiON

amI1lll (0-1) ToatIt. A tooth traumatized by a blow or other cause can die over along period of urne with or without orthodonteaunent,. This.tooth may discolor or f1ar. up during orth~ontlc:: movement and require endo~ tt'8Il1meM (root c.nal~. . .

OoRda_Cklcumnell -At ~in times during the tnatment and retention,patients may exPerience . varvln.. of dllcomforhey m-v allo notice feci.1 c and speech chenges. -

nIdtnd Ocicu. - e"",ts such swallowing applJancet. chipping teeth, or dislodging lWStDI8ti0n5 occur inftllqUtntly_

ERIODoNTAL PROBLEMS (gum d ) - This conditi~ can be present .before or dlIvelop during tmdmlnt. It cauld deterioreuring trwaanent c:wiin.g laM of bone around the teeth along withstripping or gum reeeaiotr. Exeenllftt 0l1Il hVIi- and tnqueophylaxis by your dentist Ca n help comrol this sitU al1on. .

FACT~WfncH THE PAnENT HAS SIGNIFICANT R~"UTV

OOPERAnON: In" walt m.jarItv of 0I'Ih0duut10c-. signIfIeInt imp _ be .e-in u'"""" time lAffJIl/orpiomind NIIIIta OICUr tn.n nan C l O D . . . . . . . . . . . ~ ~ _

.tCIt 91f:t101Jfirat/onin. fttIJowing __ willPfOb/IlIfy taI/t inMMIIiInI flWtmtrnt timflMd~ MIl'"

id.., T tnt Plan - Each individuel's trea1nIent is uniquw. Urt*rstanding and diligently foUowine InstrUl:tIonait IMPve. This especillly involves individual. W8lIljDfJ,.8 retractor (htlldgear), functionll applienca. elllCtics. or. i1JtIiner.

WEARING RETRACTOR C at -IELASrlCS- ..areforcel pIIC8d an 10 _ win m into their ptapar P G li ti O Mh. amount of time wom affecu . 111. as instrue'tildl Ifheadgear is fran the tubes or . hookI while ttl.lll1n::e is engaged. it ca n snip back and C lU s tr - ilJ j~ r,; :_ . .

N at T_ A,pO_. Poor tooth brushing incre therisk of dec8y when . Ing braca EJa:eIIlInIcnI~ ndudo

n . being selectilre in diet,. and reporting any loose bands .s ..-m as noticed, wiD t.fp minind (cIeIIci 10ft).and gum~L Routine visits (3.6 m~' to your dlrntist for claning andGlVity checb .ra nec-y. HabiII- Mau1h bre8thing. thumb, finger or lip sucking, or tongUe thlUSting (ebnarnlll llawlng) co . ptapIr .. cause reIIpse after brar;tIs 8nl remCMd.

EEPINe AP PO IN TM EN 18 M'dhd appointmen1Sere_ m y lChedullng probI8mI.ncll en uaatment'" 8einI ccnIIIIn1t1tewiU"lOafft!ct_tmentti~Both wiUlintlt optimum results.


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SCOTT D. HAMlLTON~ D.;D~S..;M.S:O.DON C. WILSON, D.D.S.

~ R T H 2 ' ' ' ' ' ' '_ '_ _C O S T A N D PAYMENT S C HE D U LE O F OFmlODONTlC TR EA11 I EN T

By law, 12CFR226, 'Aeg\llation Z, Truth in'Lendlng; we are reqUl"d to disclose the to.owing infotmaflani r i

the fOllowingma.,ner. although m uoh of it me y be nofHIPp!icable to our agreem en t

ANNUAL ~E MOUNT TOTAl OFPERCENTAGE CHARGE FINANCeD PAYMENTSRATEThe co st o f your C I'lIC litat a yearly l1It8.

You l'lav8 thB tfghl to receMt at lhIs limo an It4ImlmllOn Of UIe AMount FlnBnc!'d

aI WBn1en~" aI G O no t -.nt an -nizallan

IN l m d l e r _ . ! 5

PMN

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_-I~ ~-1--d/7< .

PAYM&NTSCHS>ULE v '5~! l(t.,DO ~The Installment payments are due to be paid In full aaCh lJIOftth!( whatever per iod otbetwise'ureed upon). .If a payment is more than 30 days late, you wUlbe charged ~10.001o each tatepayment.lfthenJisstiH a need. to requeslpayment,you w iN reeeive a registered letter informing you that unlesa pa y . .is made within a weet. W8will ft~ It nllC8Sll8lY to funCllonfor the. next lt1irty days in this manner: ,.... / .

1. We Wil l t~at only em ergencies (this does not m e a n ~ t re a tm e nt a dJ ua tm e nt a).2. We will-allow yOU to seek the servk:es of anoth8r:d8nt1stor.~ontistfO continue t reatment.3 . W e w i ll r em o v e t h e a pp l ia n c es aftIIr yo u have.ed a releeaeform .

Ifyou failtopayyouraa:ount in 1uUdurlngthi$thltty-dayperiod, ot if you choosetoseektr8atmer1t8lsewheleorhIMltteepplilnces. removed, an obligation on the partafouroffiCeceases. Atthattimeouroffk:e would. howtMIr. f8B9IV81herlghttocouec:.theamount

due us for the work WG have already completed. t ' \ : '-" a dleCk Is returned to 0111' offlce by the ba nk for a ny N as on there w ID b e a \fa G.G O m ed check c harge. .

I a g re e t o be responeibIe for any reasonable coI ler:1fon costs or atIOmey f ~ in CClf tecf ing 8 d8llnquent a .c :eo u n t. .;ORTHODONTIC eM.AGES '-_... "

OUr fee inctude8 reasonable orthodontic cam. DURING OATHODONTICSERVICES YOUR GENERAL DENT~ CARE AN DREGULAR EXAMS FOR CAVITIES ARE THE RESPONSIBIlITY OF YOUR R&GUlAR DENTIST. A ddllIo naI charges W i'll bem a d e f o r lo e t o r b r o ken a pp l la n c es o rf a r n a n -eo o pe f tl tl o n .b y t h e pa ti ent a f te r d ls c : uss lo n w I Ih t he r upo n a ib l e pa r ty . Ou r s e rv ic eswIDbe diecont lnued for l ack of coopera t l on o r fa i lUn l i to ec lhe re to m e abOve financial agl8Bmenl We schedu le our a ppoillbnenlsa t cn e t o e i gm w eek i n t e rv a l s. Th e fn lqUl! !ncy o f appo intmeo1ts h a s n o b ea r f n g o n ti le f ee .

M d it io n a l ph a s es o f b 8 a tr n a nf m a y b e n eed B d, es pec ia l ly if i n phase I o r ea r l y t teetment. and m ay I1IquInJ addI t Icnai fees. T het'88 inc:ludes offtce vlslt8 and rad' lOg18phS to r up to two years of retention after which 1het8 will be a fee far additio"a1 services asneeded.

'n the event "twe a re unable to com plete lite couree of llCtiVe orttlOdontk: InIa1menl clIe to the Patients moving from 1hecommunity, or for oIher unfontseeabIe reasons, it Ia to be mutually understood Ihat the account w 'a ll be ~ted and adjustedacco rd ing t o aC lUa l serv ices rem fe red up to 111Moftran8fet. There wDl be a charge for duplicat ion and t rans fe r o f reco rds . UnCfer

such cohditions, no further obligation win be eseumed by Ots. Hamnlan and WHson, P.A. .T o avoid any m i sund&rs tand lng, we w i ll be heppy t o d i9cuss .the abtMt ln fOrm aI Ion Wi lh yOU.

- - -- P lEA SE. ~ ILeT H IS Le;rTERFOR F U T UA E R EF ER EN C E _

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IIItsPon81b~~' . "".' AM~IIOfllllie. Party

(~.~1 \~\ _VOtf!ce'~ . -- .DB-I&---------

SWWestport Drive

p e ka . K S 6 6 61 478S) 172-3722


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PATIENT CONTRACT

741 DOMBROWSKI MONTHLY090.976

TOT-UNCHARGED: 4485.00 TOT-BAL: 5485.00INITIAL FEE 1000.00 INS-HAL: .00DATE-DRAWN 10/12/09 PAT-BAL: 5485.00

NEXT CHARGE 11/20/09 CUR-BAL: 1000.00

ORIG PAT+INS 5485.00' '!'HIS-MO: 1000.00

? A T I E N TCHARGE TP CHARGE TP CHARGE TP CHARGE

M NovO 9 150.00 C 13 Nov10 150.00 C 25 Nov 11 150.00 C 37 Nov12

Dec09 150.00 C 14 DeclO 150.00 C 26 Dec11 150.00 C 38 Dec12& Janl0 150.00 C 15 Jan11 150.00 C 27 Jan12 150.00 C 39 Jan134 PeblO 150.pO C 1 6 Febl1 150.00 C 28 Feb12 150.00 C 40 Feb13

5 MarlO 150.00 C 17 Marll 150.00 C 29 Mar12 150.00 C 41 Marl 3

6 Apr10 150.00 C 18 Aprll 150.00 C 30 Apr12 135.00 C 42 Aprl37 Mayl0 150.00 C 19 May11 150.00 C 31 Mayl2 43 May138 JunlO 150.00 C 20 Junll 150.00 C 32 Jun12 44 Jun13

9 Jul10 150.00 C 21 Ju111 150.00 C 33 Jul12 45 Jul13

0 AuglO 150.00 C 22 Augll 150.00 C 34 Aug12 46 Augl3

1 SeplO 150.00 C 23 Sepll 150.00 C"35 Sep1247 Sep13

2 OctlO 150.00 C 24 Oct!1 150.00 C 36 Oct12 48 Oct13

2010 Jan. 28 --Order for Parenting Time 28 Jan. 2010

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Transcript of 2010 Jan. 28 --Order for Parenting Time 28 Jan. 2010