Sca-Fc-128 Worksheet For Individual Proposed Parenting Plan (Page 2 of 4) in pdf

(E)

Development of social skills.

Examples: teaching the child how to develop proper personal relationships with friends,

brothers and sisters, and adults.

Mother ___%

Father ___%

(F)

Health care.

Examples: Making arrangements and appointments for health care; accompanying child

to doctor’s and dentist’s appointments; discussing child’s health care needs with doctors,

dentists, and other health care providers; providing care in the home when child is ill.

Mother ___%

Father ___%

(G)

Moral and religious matters.

Examples: Discussing moral and religious matters with the child; providing moral and

religious guidance; accompanying the child to church.

Mother ___%

Father ___%

(H)

Child care matters.

Examples: Making arrangements for child care by family members, baby-sitters, or child

care facilities; supervising and communicating with these child care providers.

Mother ___%

Father ___%

MAKING MAJOR DECISIONS FOR THE CHILDREN

Explain how you and your spouse have shared the responsibilities for making major

decisions for your children. This information is for only the last twelve months before your

divorce was filed. Do not provide information for any time after the filing of the divorce.

First, review the types of decisions in the list, then answer the following question.

Did you and your spouse always make the types of major decisions on the list by talking

the decision over, and coming to an agreement on what the decision should be?

___ Yes ___ No

If you answered “Yes,” you don’t need to complete the list; you’re finished with this

section. If you answered “No,” read item 2.

Complete the list by indicating the percentage of time each type of decision was shared,

which means you and your spouse talked the decision over and came to an agreement on

the decision; or the percentage of time each type of decision was made Mother, or Father,

alone, without talking it over. For each type of decision, the numbers in all of the blanks

should always add up to 100. In items (F) and (G), you may write in other types of major

decisions, and complete those items just as you completed the first part of the list.

This list is for the children named: ________________________________________.

(A) Education. Shared ___% Mother ___% Father ___%

(B) Non-emergency health care. Shared ___% Mother ___% Father___%

(D) Child care. Shared ___% Mother ___% Father ___%

SCA-FC-128 (12/01)

Worksheet for Individual Proposed Parenting Plan

Page 2 of 4

Sca-Fc-128 Worksheet For Individual Proposed Parenting Plan Page 2

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