Supervised Visitation Payment Form

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Supervised Parenting Time Qualified supervision monitor is present throughout the entire visitation session, monitor provides neutral observation and minimal coaching in a safe and private space. Observations are documented for all sessions. (90 minutes)

$120.00 Quantity
Item subtotal:$0.00

Transitional Parenting TimeSemi-Private visitation session monitored periodically by a qualified supervision monitor, providing check-ins every 15 minutes. Observation/ documentation will reflect the 15-minutes check-ins. (90 minutes)

$100.00 Quantity
Item subtotal:$0.00

One-Way Monitored Exchange No contact exchange when transferring the children from one parent to the other. All exchanges are supervised and performed by The Price Dynamic staff by appointment. *Additional cost for 2-way exchange please contact our office to discuss details

$50.00 Quantity
Item subtotal:$0.00

Supportive Coaching Visitation Qualified supervision monitors offer parenting education and coaching interventions to enhance the parent/child relationship in a safe and private space. The Price Dynamic staff will coach parent and child to build skills leading toward re-newing, re-unification, or establishing a nurturing and healthy relationship.Observations are documented for all sessions. (90 minutes)

$150.00 Quantity
Item subtotal:$0.00

Split Payment Parents who are ordered to split the cost of supervised visitation services can use this link to pay their portion of the service fee for standard supervised visitation appointments which cost $120.00 per visit.

$60.00 Quantity

Total

$0.00

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Visiting Parents Name

First NameLast Name

E-mail

Billing Address

Street Address

Street Address Line 2

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Postal / Zip CodeCountry