Fillable Printable Parenting Plan Example - Arizona
Fillable Printable Parenting Plan Example - Arizona
Parenting Plan Example - Arizona
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Name of Person Filing:
Street Address:
City, State, Zip Code:
Telephone Number:
Email Address:
ATLAS Number (if applicable):
Representing Self (No Attorney) or Represented by Attorney
If Attorney, Bar Number:
SUPERIOR COURT OF ARIZONA
PINAL COUNTY
CASE NUMBER:
DO
Name of Petitioner
PARENTING PLAN FOR:
JOINT LEGAL DECISION-MAKING
OR
SOLE LEGAL DECISION-MAKING
TO PETITIONER
TO RESPONDENT
Name of Respondent
HONORABLE:
GENERAL INFORMATION
A. MINOR CHILDREN This Plan concerns the following children common to the parents:
Name Birth Date
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B. LEGAL DECISION-MAKING: Select One. If you select sole legal decision-making, you have the option
of also selecting restrictions on the parenting time of the other parent.
SOLE LEGAL DECISION-MAKING
Sole legal decision-making should be granted to
Petitioner or
Respondent
JOINT LEGAL DECISION-MAKING
Both parents will make major educational decisions together.
Optional: If the parents do not agree, select one
the final decision will be with Petitioner
the final decision will be with Respondent
the decision will be addressed as follows:
Both parents will make major religious decisions together.
Optional: If the parents do not agree, select one
the final decision will be with Petitioner
the final decision will be with Respondent
the decision will be addressed as follows:
Both parents will make major medical decisions together.
Optional: If the parents do not agree, select one
the final decision will be with Petitioner
the final decision will be with Respondent
the decision will be addressed as follows:
Both parents will make major personal care decisions together.
Optional: If the parents do not agree, select one
the final decision will be with Petitioner
the final decision will be with Respondent
the decision will be addressed as follows:
C. PARENTING TIME Write your detailed parenting plan below. Include specific times, locations, and details
regarding transportation. You will have the opportunity to request supervised parenting time or no
parenting time, later in this document.
1. Regular Parenting Time:
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2. Summer Months:
3. School Breaks Longer Than 4 Days:
4. Three Day Weekends:(for example, Labor Day, Columbus Day, Martin Luther King, Jr. Day,
Presidents' Day and Memorial Day)
The parents agree that whichever of them has the child(ren) for the weekend occurring nearer in time
to the holiday will spend time with the child(ren) for the holiday, OR
Explain your request:
5. Transportation: Write your procedure for exchanges of the child(ren) including location and
responsibility for transportation.
6. Holiday, Birthday and Special Occasion Schedule Use the table below or the blank space to write
your schedule.
Event Even Years Odd Years
New Year’s Eve Petitioner Respondent Petitioner Respondent
New Year’s Day Petitioner Respondent Petitioner Respondent
Easter Petitioner Respondent Petitioner Respondent
4
th
of July Petitioner Respondent Petitioner Respondent
Halloween Petitioner Respondent Petitioner Respondent
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Veteran’s Day Petitioner Respondent Petitioner Respondent
Thanksgiving Petitioner Respondent Petitioner Respondent
Christmas Eve Petitioner Respondent Petitioner Respondent
Christmas Day Petitioner Respondent Petitioner Respondent
Child(ren)’s Birthday Petitioner Respondent Petitioner Respondent
Mother’s Day Petitioner Respondent Petitioner Respondent
Father’s Day Petitioner Respondent Petitioner Respondent
Petitioner’s Birthday Petitioner Respondent Petitioner Respondent
Respondent’s Birthday Petitioner Respondent Petitioner Respondent
7. Telephone Contact with Children
Each parent may have telephone contact with the child(ren) during the child(ren)’s normal waking
hours, OR
Explain your request:
8. Travel with Child(ren) (all of the following are optional)
Each parent is entitled to consecutive days of vacation time per year with the child(ren). Each
parent will give the other parent days notice prior to the vacation.
Should either parent travel out of the area with the minor child(ren), each parent will keep the other
parent informed of travel plans, address(es), and telephone numbers at which that parent and the minor
child(ren) can be reached.
Neither parent shall travel with the minor child(ren) outside of Arizona for longer than ______ days
without the prior written consent of the other parent or order of the court.
SUPERVISED PARENTING TIME
Supervised parenting time is in the best interest of the minor child(ren) because:
Name of the agency or person who will supervise:
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NO PARENTING TIME BETWEEN CHILD(REN) AND
PETITIONER
OR
RESPONDENT
No parenting time is in the best interest of the minor child(ren) because:
D. Medical and Dental Arrangements
Both parents have the right to authorize emergency medical treatment, if needed, and the right to
consult with physicians and other medical practitioners. Both parents agree to advise the other parent
with physicians and other medical practitioners. Both parents agree to advise the other parent
immediately of any emergency medical/dental care sought for the minor children, to cooperate on health
matters concerning the children and to keep one another reasonably informed. Both parents agree to
keep each other informed as to names, addresses and telephone numbers of all medical/dental care
providers.
E. Other Arrangements
Each parent will inform the other parent of any change of address and/or phone number in advance
OR within days of the change.
Both parents will promptly inform the other parent of any emergency or other important event that
involves the minor children.
Both parents will consult and agree with the other parent regarding any extra activity that affects the
minor children’s access to the other parent.
Each parent will consider the other parent as care-provider for the minor children before making other
arrangements.
Each parent will keep all communication regarding the minor child(ren) between the parents and will
not use the minor child(ren) to convey information or to set up parenting time changes.
Each parent will encourage love and respect between the minor child(ren) and the other parent and
neither parent shall do anything that may hurt the other parent’s relationship with the minor children.
Both parents will exert their best efforts to work cooperatively in future plans consistent with the best
interests of the minor children and to amicably resolve such disputes as may arise.
If either parent is unable to follow through with the time-sharing arrangements involving the minor
child(ren), that parent will notify the other parent as soon as possible.
Both parents agree that if either parent moves out of the area and returns later, they will use the most
recent “Parenting Plan/Access Agreement” in place before the move.
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If the parents are unable to reach a mutual agreement regarding a legal change to their parenting
orders, they will request mediation through the court or a private mediator of their choice.
Obtain Written Consent or Court Order Before Moving: Notice required by ARS 25-408 shall be made
by certified mail, return receipt requested, or pursuant to the Arizona rules of family law procedure. The
court shall sanction a parent who, without good cause, does not comply with the notification requirements
of this law. The court may impose a sanction that will affect the legal decision-making or parenting time
only in accordance with the child’s best interests.
Parental Access to Records and Information Pursuant to Arizona law, unless otherwise provided by
court order or law, on reasonable request both parents are entitled to have equal access to documents
and other information concerning the minor child(ren)’s education and physical, mental, moral and
emotional health including medical, school, police, court and other records. A person who does not
comply with a reasonable request for these records shall reimburse the requesting parent for court costs
and attorney fees incurred by that parent to make the other parent obey this request. A parent who
attempts to restrict the release of documents or information by the custodian of the records without prior
court order is subject to legal sanctions.
Notice: Do not deviate from Parenting Plan until dispute is resolved. Both parents are advised that while a
dispute is being resolved, neither parent shall deviate from this Parenting Plan or act in a way that is
inconsistent with the terms of this agreement.
Once this plan has been made an order of the Court, if either parent disobeys the court order related to
parenting time with the children, the other parent may submit court papers to request enforcement.
SIGNATURE OF ONE OR BOTH PARENTS
Signature of Petitioner: Date:
Signature of Respondent: Date:
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IF YOU ARE REQUESTING SOLE LEGAL DECISION MAKING, THE FORM IS COMPLETE. DO NOT SIGN
SECTION F OR G.
F. STATEMENT REGARDING CONACT WITH SEX OFFENDERS AND PERSONS CONVICTED OF
DANGEROUS CRIMES AGAINST CHILDREN.
According to A.R.S. §25-403.05, a child’s parent or custodian must immediately notify the other parent or
custodian if the person knows that a convicted or registered sex offender or someone who has been convicted of
a dangerous crime against children may have access to the child.
According to A.R.S. §13-705 (P) (1), “Dangerous crime against children” means any of the following that is
committed against a minor who is under fifteen years of age:
(a) Second degree murder.
(b) Aggravated assault resulting in serious physical injury or involving the discharge, use or threatening
exhibit on of a deadly weapon or dangerous instrument.
(c) Sexual assault.
(d) Molestation of a child.
(e) Sexual conduct with a minor.
(f) Commercial sexual exploitation of a minor.
(g) Sexual exploitation of a minor.
(h) Child abuse as prescribed in section 13-3623, subsection A, paragraph 1.
(i) Kidnapping.
(j) Sexual abuse.
(k) Taking a child for the purpose of prostitution as prescribed in section 13-3212.
(l) Child prostitution as prescribed in section 13-3212.
(m) Involving or using minors in drug offenses.
(n) Continuous sexual abuse of a child.
(o) Attempted first degree murder.
(p) Sex trafficking.
(q) Manufacturing methamphetamine under circumstances that causes physical injury to a minor.
(r) Bestiality as prescribed in section 13-1411, subsection A, paragraph 2.
(s) Luring a minor for sexual exploitation.
(t) Aggravated luring a minor for sexual exploitation.
(u) Unlawful age misrepresentation.
The parent or custodian must provide notice by first class mail, return receipt requested, by electronic means to
an electronic mail address that the recipient provided to the parent or custodian for notification purposes or by
another form of communication accepted by the court.
I/We have read, understand, and agree to abide by the requirements of A.R.S. §25-403.05(B) concerning
notification of other parent or custodian if someone convicted of dangerous crime against children may have
access to the child.
Signature of Petitioner: Date:
Signature of Respondent: Date:
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G. JOINT LEGAL DECISION-MAKING: If requested or agreed to by the parties, the following will
apply, subject to approval by the Judge:
1. DOMESTIC VIOLENCE: Arizona Law (A.R.S. §25-403.03) states that joint Legal Decision-Making
shall NOT be awarded if there has been “a history of significant domestic violence”.
Domestic Violence has not occurred between the parties, OR
Domestic Violence has occurred but it has not been “significant” or has been committed by both
parties.* Complete Section 3 below.
2. DUI or DRUG CONVICTIONS:
Neither party has been convicted of driving under the influence or a drug offense within the past 12
months, OR
One of the parties HAS been convicted of driving under the influence or a drug offense within the past
12 months, but the parties feel Joint Legal Decision-Making is in the best interest of the children. *
Complete Section 3 below.
3. * IF THERE HAS BEEN DOMESTIC VIOLENCE OR A DUI OR DRUG CONVICTION:
Explain why Joint Legal Decision-Making is still in the best interests of the children:
4. REVIEW: The parents agree to review the terms of the / this agreement and make any necessary or
desired changes every months from the date of this document.
5. CRITERIA. Our joint Legal Decision-Making agreement meets the criteria required by Arizona law
A.R.S. §25-403.02, as listed below:
a. The best interest of the minor children are served;
b. Each parent’s rights and responsibilities for personal care of the minor children and for decisions
in education, health care and religious training are designated in this Plan;
c. A schedule of the physical residence of the minor children,, including holidays and school
vacations is included in the Plan;
d. The Plan includes a procedure for periodic review;
e. The Plan includes a procedure by which proposed changes, disputes and alleged breaches may
be mediated or resolved;
f. A procedure for communicating with each other about the child, including methods and
frequency.
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SIGNATURE OF PARENT(S) REQUESTING JOINT LEGAL DECISION-MAKING
Signature of Petitioner: Date:
Signature of Respondent: Date:
