PARENTING PLAN ADDENDUM TO HISTORY FORM

Transcription

1 PARENTING PLAN ADDENDUM TO HISTORY FORM (Please complete this form without assistance from any one. Please read the entire form before beginning so that you will not duplicate information that may be requested later on the form.) Please briefly summarize the reason this evaluation is needed. Please list (bullet list rather than description please) all allegations/concerns/conflicts you would like to have addressed by the evaluation: Please list (bullet list rather than description please) all allegations/concerns/conflicts you believe the other parent would like to have addressed by the evaluation: Describe your relationship with your child(ren).

2 Page 2 of 6 Describe your (former) spouse s relationship with your child(ren). How do you discipline your child(ren)? How does your (former) spouse discipline your child(ren)? Describe your strengths as a parent. Describe your weaknesses as a parent. Describe your (former) spouse s strengths as a parent. Describe your (former) spouse s weaknesses as a parent. What will your (former) spouse say about your strengths and weaknesses? Describe your current work schedule (please be as specific as possible including days, times, overnight travel, etc.)?

3 Page 3 of 6 Do you anticipate any changes in your work schedule? If so, please explain. If your work schedule is different than during the time of the marriage or when residing together as a family please explain the basis of that change. Other than work please describe any specific events/activities/obligations that preclude you from being with your child(ren) at a particular day or time? Who cares for your child(ren) when you are not at home or available to be with them? Do you require assistance with transportation of the child(ren) to school, extracurricular activities, doctor s appointments, parent contact exchanges, etc.? If yes, how often and who assists you? What is the current parent-child time-sharing schedule? Are there any problems with the weekly time-sharing schedule not otherwise described above? If so please describe. What weekly parent-child time-sharing schedule would you recommend? Please explain why you believe that is the best schedule for the children.

4 Page 4 of 6 On the attached Holiday Schedule please indicate the current schedule and any changes that you propose. What Holidays/Special Days/Days off of School are particularly important to you? In addition to the time-sharing schedule how would you recommend sharing parenting with your (former) spouse? What is your suggestion for how the daily tasks of parenting should be handled? Are you requesting to be responsible for or make decisions solely about any particular area of parenting? If so please describe and indicate why you believe that is necessary. Briefly describe each yours and the other parent s proposed solution to all perceived problems: Your solution Other parent s solution Parent Name and Signature Date (By signing this document you attest that you personally completed this form without any assistance from another individual including your current spouse, friends, parents, therapist, attorney, custody coach, etc.)

5 Page 5 of 6 HOLIDAY Martin Luther King, Jr. Day/Weekend Presidents Day/Weekend Spring Break Easter Sunday (if observed) Mother s Day Memorial Day/Weekend Father s Day Independence Day Labor Day/Weekend Rosh Hashana (if observed) Yom Kippur (if observed)

6 Page 6 of 6 Thanksgiving Day and Break Christmas Eve/Christmas Day (if observed) New Year s Eve/Day Winter Break Non-Holiday Days off of School Summer Break Uninterrupted Vacation (Summer or otherwise) Other Religious Holidays (if observed) Child s Birthday Parent s Birthday Parent s Birthday l:\forms\2013 forms\history forms\2013 parenting plan addendum with holiday schedule.doc