New Parenting Plan Intake Form

New Parenting Plan Intake Form
This parenting plan is: (Choose only one)

A Parenting Plan submitted to the court with the agreement of the parties.A proposed Parenting Plan submitted by or on behalf of petitioner/respondentA Parenting Plan established by the court.
This parenting plan is: (Choose only one)

A final Parenting Plan established by the court.A temporary Parenting Plan established by the court.A modification of a prior final Parenting Plan or prior final order.
Are you the respondent or the petitioner?
Parents Information
Mother's Name*

First NameLast Name
Address Unknown
Please indicate here if mother’s address is unknown
Address Confidential
Please indicate here if the mother’s address and phone numbers are confidential
Address Confidential (2)
Please indicate here by what order the mother’s address and phone numbers are confidential
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Father's Name*

First NameLast Name
Address Unknown
Please indicate here if mother’s address is unknown
Address Confidential
Please indicate here if the mother’s address and phone numbers are confidential
Address Confidential (2)
Please indicate here by what order the mother’s address and phone numbers are confidential
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Children
This parenting plan is for the following child(ren) born to, or adopted by the parties:(add additional lines as needed)*
PARENTAL RESPONSIBILITY AND DECISION MAKING
Parental Responsibility (Choose only one)

Shared Parental Responsibility. It is in the best interests of the child(ren) that the parents confer and jointly make allmajor decisions affecting the welfare of the child(ren). Major decisions include, but arenot limited to, decisions about the child(ren)’s education, healthcare, and otherresponsibilities unique to this family.Shared Parental Responsibility with Decision Making AuthorityIt is in the best interests of the child(ren) that the parents confer and attempt to agreeon the major decisions involving the child(ren).Sole Parental Responsibility
If the parents are unable to agree, the authority for making major decisions regarding the child(ren) shall be as follows:
If sole parental responsibility; it is in the best interests of the child(ren) that the Father shall have sole authority to make major decisions for the child(ren.) It is detrimental to the child(ren) to have shared parental responsibility.
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Extra-curricular Activities ( Choose all that apply)

Either parent may register the child(ren) and allow them to participate in the activity ofthe child(ren)’s choice.The parents must mutually agree to all extra-curricular activities.The parent with the minor child(ren) shall transport the minor child(ren) to and/or fromall mutually agreed upon extra-curricular activities, providing all necessary uniforms andequipment within the parent’s possession.The costs of the extra-curricular activities shall be paid by both parentsThe uniforms and equipment required for the extra-curricular activities shall be paid by both parentsOther
If selected option 4 and/or 5 above, provide a breakdown of cost to be paid by both parents
If Other selected, please specify
INFORMATION SHARING.

Unless otherwise indicated or ordered by the Court, skip this section.
Unless otherwise prohibited by law, each parent shall have access to medical and school records and information pertaining to the child(ren) and shall be permitted to independently consult with any and all professionals involved with the child(ren). The parents shall cooperate with each other in sharing information related to the health, education, and welfare of the child(ren) and they shall sign any necessary documentation ensuring that both parents have access to said records.

Each parent shall be responsible for obtaining records and reports directly from the school and Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11) health care providers.

Both parents have equal rights to inspect and receive governmental agency and law enforcement records concerning the child(ren).

Both parents shall have equal and independent authority to confer with the child(ren)’s school, day care, health care providers, and other programs with regard to the child(ren)’s educational, emotional, and social progress.

Both parents shall be listed as “emergency contacts” for the child(ren).

Each parent has a continuing responsibility to provide a residential, mailing, and contact address and contact telephone number to the other parent. Each parent shall notify the other parent in writing within 24 hours of any changes. Each parent shall notify the court in writing within seven (7) days of any changes.
Additional information
SCHEDULING
If necessary, on or before of each year, both parents should obtain a copy of the school calendar for the next school year. The parents shall discuss the calendars and the time-sharing schedule so that any differences or questions can be resolved.
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The parents shall follow the school calendar of: (Choose all that apply)

the oldest childthe youngest childthe school calendar for specific Countythe school calendar for specific School
If selected, please insert specific county or school
Schedule Changes (Choose all that apply)

A parent making a request for a schedule change will make the request as soon as possible, but in any event, except in cases of emergency, provide update within agreeable time frame.A parent requesting a change of schedule shall be responsible for any additional childcare, or transportation costs caused by the change.Other
If option 1 was selected above, insert desired time frame.
If Other was selected, please specify.
TIME-SHARING SCHEDULE
Weekday and Weekend Schedule:

The following schedule shall apply beginning on with the and continue as follows:

The child(ren) shall spend time with the Mother on the following dates and times: WEEKENDS: (every, every other, other-specify) from to

WEEK Days: (every, every other, other-specify) from to

Other: (Specify)

The child(ren) shall spend time with the Father on the following dates and times: WEEKENDS: (every, every other, other-specify) from to

WEEK Days: (every, every other, other-specify) from to

Other: (Specify)
Please indicate if there is a different time sharing schedule for any child.
File Upload

Complete a separate Attachment for each child for whom there is a different time sharing schedule.
Cancelof
Holiday Schedule (Choose only one)

No holiday time sharing shall apply. The regular time-sharing schedule set forth aboveshall apply.Holiday time-sharing shall be as the parties agree.Holiday time-sharing shall be in accordance with the following schedule. The Holidayschedule will take priority over the regular weekday, weekend, and summer schedules.Fill in the blanks with Mother or Father to indicate where the child(ren) will be for theFlorida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)holidays. Provide the beginning and ending times. If a holiday is not specified as even,odd, or every year with one parent, then the child(ren) will remain with the parent inaccordance with the regular schedule
Holiday Breakdown
This holiday schedule may affect the regular Time-Sharing Schedule. Parents may wish to specify one or more of the following options:

When the parents are using an alternating weekend plan and the holiday schedulewould result in one parent having the child(ren) for three weekends in a row, theparents will exchange the following weekend, so that each has two weekends in a rowbefore the regular alternating weekend pattern resumes.If a parent has the child(ren) on a weekend immediately before or after an unspecifiedholiday or non-school day, they shall have the child(ren) for the holiday or non-schoolday.
Winter Break (Choose only one)

The Mother shall have the child(ren) from the day and time school is dismissed until specified time in odd-numbered years every year. The other parent will have the children for the second portion of the Winter Break. The parties shall alternate the arrangement each year.The Mother shall have the child(ren) from the day and time school is dismissed until specified time in even-numbered years every year. The other parent will have the children for the second portion of the Winter Break. The parties shall alternate the arrangement each year.The Father shall have the child(ren) from the day and time school is dismissed until specified time in odd-numbered years every year. The other parent will have the children for the second portion of the Winter Break. The parties shall alternate the arrangement each year.The Father shall have the child(ren) from the day and time school is dismissed until specified time in even-numbered years every year. The other parent will have the children for the second portion of the Winter Break. The parties shall alternate the arrangement each year.The Mother shall have the child(ren) for the entire Winter Break during every yearThe Mother shall have the child(ren) for the entire Winter Break during even numbered yearThe Mother shall have the child(ren) for the entire Winter Break during odd numbered yearThe Father shall have the child(ren) for the entire Winter Break during every yearThe Father shall have the child(ren) for the entire Winter Break during even numbered yearThe Father shall have the child(ren) for the entire Winter Break during odd numbered year
Specified Time
Spring Break (Choose only one)

The parents shall follow the regular scheduleThe parents shall alternate the entire Spring Break with the Mother having thechild(ren) during the odd numbered yearThe parents shall alternate the entire Spring Break with the Mother having thechild(ren) during the even numbered yearThe Father shall have the child(ren) for the entire Spring Break every year.The Mother shall have the child(ren) for the entire Spring Break every year.The Spring Break will be evenly divided. The first half of the Spring Break will go to theparent whose regularly scheduled weekend falls on the first half and the second halfgoing to the parent whose weekend falls during the second half.Other
If Other was selected, please specify
Summer Break (Choose only one)

The parents shall follow the regular schedule through the summer.Type option 2Type option 3Type option 4
Number of Overnights:

Based upon the time-sharing schedule, the Mother has a total of blanks overnights per year and the Father has a total of overnights per year.

Note: The two numbers must equal 365.
TRANSPORTATION AND EXCHANGE OF CHILD(REN)
Transportation (Choose only one)

The Mother shall provide all transportation.The Father shall provide all transportation.The parent beginning their time-sharing shall provide transportation for the child(ren).The parent ending their time-sharing shall provide transportation for the child(ren).Other
If Other selected, specify
Exchange: Both parents shall have the child(ren) ready on time with sufficient clothing packed and ready at the agreed upon time of exchange. If a parent is more than ______ minutes late without contacting the other parent to make other arrangements, the parent with the child(ren) may proceed with other plans and activities. (Choose only one):

Exchanges shall be at Mother’s and Father’s homes unless both parents agree to adifferent meeting place.Exchanges shall occur at a meeting spotOther
If meeting spot selected, specify
If Other selected, specify
Transportation Costs (Choose only one)

Transportation costs are included in the Child Support Worksheets and/or the Order forChild Support and should not be included here.Parents shall share the costOther
If shared cost is selected, specify
If Other is selected, specify
Foreign and Out-Of-State Travel (Fill in applicable option)
1. Either parent may travel within the United States with the child(ren) during his/her time-sharing. The parent traveling with the child(ren) shall give the other parent at least days written notice before traveling out of state unless there is an emergency, and shall provide the other parent with a detailed itinerary, including locations and telephone numbers where the child(ren) and parent can be reached at least days before traveling.
2. Either parent may travel out of the country with the child(ren) during his/her timesharing. At least days prior to traveling, the parent shall provide a detailed itinerary, including locations, and telephone numbers where the child(ren) and parent may be reached during the trip. Each parent agrees to provide whatever documentation is necessary for the other parent to take the child(ren) out of the country.
3. If a parent wishes to travel out of the country with the child(ren), he/she shall provide the following security for the return of the child
4. Other (Specify)
EDUCATION
School designation: For purposes of school boundary determination and registration, the[ ] Mother’s [ ] Father’s address shall be designated.

For purposes of school boundary determination and registration, the Mother’s address shall be designated.For purposes of school boundary determination and registration, the Father’s address shall be designated.
(If Applicable) The following provisions are made regarding private or home schooling:
Other (Specify)
DESIGNATION FOR OTHER LEGAL PURPOSES
Designation (Choose only one)

The child(ren) named in this Parenting Plan are scheduled to reside the majority of the time with the Mother. This majority designation is SOLELY for purposes of all other state and federal laws which require such a designation. This designation does not affect either parent’s rights and responsibilities under this Parenting Plan.The child(ren) named in this Parenting Plan are scheduled to reside the majority of the time with the Father. This majority designation is SOLELY for purposes of all other state and federal laws which require such a designation. This designation does not affect either parent’s rights and responsibilities under this Parenting Plan.
COMMUNICATION

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)
Between Parents: All communications regarding the child(ren) shall be between the parents. The parents shall not use the child(ren) as messengers to convey information, ask questions, or set up schedule changes.The parents shall communicate with each other: (Choose all that apply)

in personby telephoneby letterby e-mailOther
If Other was selected, please specify
The child(ren) may have [ ] telephone [ ] e-mail [ ] other electronic communication in the form of ___________________________________ with the other parent: (Choose only one)

AnytimeEvery day during specific hoursOn specific daysOther
If option 2-4 selected, please specify
Costs of Electronic Communication shall be addressed as follows:
Other Provisions
Should be Empty:

New Parenting Plan Intake Form

Parents Information

Children

PARENTAL RESPONSIBILITY AND DECISION MAKING

INFORMATION SHARING.

SCHEDULING

TIME-SHARING SCHEDULE

TRANSPORTATION AND EXCHANGE OF CHILD(REN)

EDUCATION

DESIGNATION FOR OTHER LEGAL PURPOSES

COMMUNICATION