PARENTING PLAN - SCA-FC-121 - Review Date 05/2014

Sep 25, 2026

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Parenting Plan form for use in the Family Court, outlining proposed parenting time and related decisions for children of the petitioner and respondent. Includes sections to list each child’s name and date of birth, select whether restrictions apply, and record reasons for any restrictions. Provides detailed options for visitation, including supervised visitation and supervised transfers, specifying who supervises and relevant contact details. Covers decision-making rules for day-to-day and emergency health or safety decisions, plus major decision responsibilities.

LanguageEnglish

CategoryForms

FormatPDF

Pages15

Reading Time5 min

AccessFree to download

PARENTING PLAN

CHILDREN

RESTRICTIONS

CONDUCT THAT CAN REQUIRE PARENTAL RESTRICTIONS.

Reasons for Restrictions:

VISITATION

SUPERVISED VISITATION

SUPERVISED TRANSFERS

Other Proposed Restrictions:

DECISIONMAKING

Major Decisions

IN THE FAMILY COURT OF IN RE: The Marriage/Children Of: Respondent(First/Middle/Last) Petitioner(First/Middle/Last) # PARENTING PLAN This Parenting Plan is proposed ,the Petitioner/□Respondent.*Every Individual Plan must be accompanied by a completed Worksheet. This plan is proposed for use temporarily/ permanently/ both temporarily and permanently. CHILDREN List the name and date of birth of all children subject to this Parenting Plan. | Name | Date of Birth | Name | Date of Birth | | --- | --- | --- | --- | | | /
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/ | The other parent should not have parenting time with the children due to the following: # RESTRICTIONS The Family Court can restrict a parent's contact with the children if the parent has engaged in certainkinds of conduct harmful to the children.To begin,you must read the following list of types of conduct thatcan require restrictions,and then you must read the rest of the Restrictions section and complete the items thatapply to your situation. ## CONDUCT THAT CAN REQUIRE PARENTAL RESTRICTIONS. ● The parent has abused,neglected,or abandoned a child. ● The parent has sexually assaulted or abused a child. ● The parent has committed acts of domestic violence. SCA-FC-121:Parenting Plan Review Date:05/2014;Revision Date:05/2014;TwVSCA Approved:06/17/2014 CONDUCT THAT CAN REQUIRE PARENTAL RESTRICTIONS(continued). ● The parent has repeatedly interfered with the other parent's rights to contact or visit the children.But,this situation does not justify restrictions if the parent interfered with the other parent's accessin order to protect a child's safety. ·The parent has repeatedly made unfounded reports of domestic violence,child abuse or neglect,orsexual abuse. ·A Court has issued a restraining order against the parent for domestic or family violence. ● The parent has neglected their responsibilities for caring for the children. ·The parent has engaged in alcohol,drug,or other substance abuse that has resulted in that parentneglecting their responsibilities for caring for the children. ● The parent does not have a loving emotional relationship with the children. ● The parent habitually starts arguments with the other parent,or the children. Next,read the rest of the section,and complete the items you want to propose for your Parenting Plan. NO RESTRICTIONS should be included in the Parenting Plan,because neither parent has engaged in anyconduct harmful to the children. RESTRICTIONS should be included in the Parenting Plan,and these restrictions should be placed on the Petitioner/ Respondent.These restrictions should be included in the Parenting Plan because thePetitioner or Respondent has engaged in conduct harmful to the children.If vou checked the "Restrictions"box.vou must complete the following section by listing the reasons vou think restrictionsshould be included in the Parenting Plan.(Describe the conduct you think requires restrictions.You maydescribe the kinds of conduct on the preceding list,or other conduct you think is harmful,even if thatconduct is not on the list.If the issuance of a restraining order is the reason for restrictions,you must listthe court in which the restraining order was issued,and the case number.) ## Reasons for Restrictions: | | | --- | | | | | | | | | | | | | | | SCA-FC-121:Parenting Plan Review Date:05/2014;Revision Date:05/2014;TwVSCA Approved:06/17/2014 If you checked the "Restrictions"box,you must complete the following items to propose the types ofrestrictions you want included in the plan. # VISITATION □No Visitation should be granted to the following individual: Petitioner. Respondent. Other Individual(s): ## SUPERVISED VISITATION Visitation with the

FAQs

What information must be provided in the Parenting Plan under CHILDREN?

List the name and date of birth of all children subject to the Parenting Plan.

When should RESTRICTIONS be included in the Parenting Plan?

Restrictions should be included if the petitioner or respondent has engaged in conduct harmful to the children; the form also notes that no restrictions should be included if neither parent engaged in harmful conduct.

What decision-making rules apply under DECISIONMAKING?

The parent with whom a child is residing makes day-to-day decisions, while either parent may make emergency decisions affecting the children’s health or safety at any time.

Sep 25, 2026

Upload by Grenda