Medical Divorce Document

A medical divorce document is a document or a formal arrangement which is made when a husband and wife file for divorce on the basis of a medical condition which is cited as a reason for the divorce. Medical divorce documents consist of the various details of the divorce and are quite important in the process of settlement of the divorce. Given below is a sample of a medical divorce document which can be used by any person as a reference document.

Sample Medical Divorce Document

Date of drafting the document: 17th June 2012

Name of husband: Mr. Tim Peterson

Name of wife: Mrs. Ruby Peterson

Number of children: 1

Name: Samantha Peterson

Age: 2 years.

Name of divorce attorney of husband: Mr. Kell Fredrick

Name of divorce attorney of wife: Mrs. Henry Black

Date of marriage: 1st September 2006

Reason for divorce stated by wife: Husband’s unbalanced state of mind/depression and mental illness

Terms and conditions to be agreed by both the parties are as follows:

  • The husband and wife have agreed mutually to get a divorce on the basis of the medical condition of the husband.
  • The husband has agreed to pay the wife an alimony amount of $30000.
  • The custody of the child shall remain with the wife as the husband has voluntary decided not to take the responsibility of the child.
  • The husband would have the right to meet the child once in a month in the presence of the wife.

Property and financial settlement

  • Both the parties shall be entitled to half the cash and bank savings etc.
  • The current residence of the parties shall remain with the husband whereas a flat situated in California would be given to the wife.

Both the parties agree to all the terms and conditions and provide their signature below:

Ruby Peterson

Tim Peterson


Posted in Divorce Documents