b. Religion: ___________________________
c. Activities: _____________________________
Name
Address and telephone
d. Doctor
___________________
________________________
e. Dentist
___________________
_________________________
f. School
___________________
_________________________
g. Child care ___________________
__________________________
h. Other
___________________
________________________
2. Solving arguments. We will resolve any parenting or time-sharing dispute regarding
our children in this way (steps continue until problem solved):
a. Talk together; or
b. Communicate in writing as follows:
i. parent requests change, and gives reasons for the change; and
ii. answering parent sends response within ____ days.
If the answering parent does not agree to the change, that parent must say
why, and, if possible, make a new proposal.
c. Take the following steps:
(check all that apply and number them if there is a particular order)
[ ] ___.
Go to couple, family, or other counseling;
[ ] ___.
Go to mediation with a neutral party;
[ ] ___.
Other: ___________________________________;
[ ] ___.
Go to court.
3. Timesharing schedule.
(Complete“Schedule 1” or “Schedule 2” below.)
[ ] Schedule 1. Same schedule each week or every two weeks.
(Set out the time that mother or father will have the children for that day.)
Week 1
Mother’s time
Father’s time
Monday
____________
______________
Tuesday
____________
______________
Wednesday
____________
______________
Thursday
____________
______________
Friday
____________
______________
Saturday
____________
______________