Parenting Plan Form

Practical Note # 1: A copy of a blank parenting plan form is as follows:

__________________COUNTY SUPERIOR COURT

STATE OF GEORGIA

__________________)
Plaintiff,) Civil Action
) Case Number ________________
vs.)
)
________________)
Defendant.)

PARENTING PLAN

( ) The parties have agreed to the terms of this plan and this information has been furnished by both

parties to meet the requirements of OCGA Section 19-9-1. The parties agree on the terms of the plan and affirm the accuracy of the information provided, as shown by their signatures at the end of this order.

( ) This plan has been prepared by the judge.

This plan( ) is a new plan.
( ) modifies an existing Parenting Plan dated ___________.
( ) modifies an existing Order dated __________________.
Child’s NameDate of Birth

I. Custody and Decision Making:

A. Legal Custody shall be (choose one:)

( ) with the Mother
( ) with the Father
( ) Joint

B. Primary Physical Custodian

For each of the children named below the primary physical custodian shall be:

d/o/b:
( ) Mother
( ) Father
( ) Joint

d/o/b:
( ) Mother
( ) Father
( ) Joint

d/o/b:
( ) Mother
( ) Father
( ) Joint

d/o/b:
( ) Mother
( ) Father
( ) Joint

d/o/b:
( ) Mother
( ) Father
( ) Joint

WHERE JOINT PHYSICAL CUSTODY IS CHOSEN BY THE PARENTS OR ORDERED BY THE COURT, A DETAILED PLAN OF THE LIVING ARRANGEMENTS OF THE CHILD(REN) SHALL BE ATTACHED AND MADE A PART OF THIS PARENTING PLAN.

C. Day-To-Day Decisions

Each parent shall make decisions regarding the day-to-day care of a child while the child is residing with that parent, including any emergency decisions affecting the health or safety of a child.

D. Major Decisions

Major decisions regarding each child shall be made as follows:

Educational decisions( ) mother ( ) father ( ) joint
Non-emergency health care( ) mother ( ) father ( ) joint
Religious upbringing( ) mother ( ) father ( ) joint
Extracurricular activities( ) mother ( ) father ( ) joint
_____________________( ) mother ( ) father ( ) joint
_____________________( ) mother ( ) father ( ) joint

E. Disagreements

Where parents have elected joint decision making in Section I.D above, please explain how any disagreements in decision-making will be resolved.

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

II. Parenting Time/Visitation Schedules

A. Parenting Time/Visitation

During the term of this parenting plan the non-custodial parent shall have at a minimum the following rights of parenting time / visitation (choose an item):

( ) The weekend of the first and third Friday of each month.

( ) The weekend of the first, third, and fifth Friday of each month.

( ) The weekend of the second and fourth Friday of each month.

( ) Every other weekend starting on _____________________.

( ) Each _____________________ starting at _____________________ a.m./p.m. and ending _____________________ a.m./p.m.

( ) Other: __________________________________________.