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PARENTING PLAN REQUESTED FOR CASE #
1.

PARENTS
Name

Parent
A

Parent
B

2.

Mailing Address

First:
Middle:

Street:
City:

Last:

State and Zip:

First:
Middle:

Street:
City:

Last:

State and Zip:

CHILDREN
Name

Birthdate Age

School

Child 1
Child 2
Child 3
Child 4
Child 5

3.

DECISION MAKING (LEGAL CUSTODY)
3.1

Major decisions (select option A, B, or C below)
Option A--The parents will share major decision making about the
children’s education, healthcare, religious training, and personal
care. If the parents reach an impasse, they will resolve their
disagreement:
with help from a trained mediator selected and paid for by both
parents.
by requesting a court hearing about the disagreement.

Option B--The parents will share major decision making in this way:
 Parent A will make major decisions about the children’s:
education
healthcare
religious training
personal
care
 Parent B will make major decisions about the children’s:
education
healthcare
religious training
personal
ca