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FORM 12.995(a),: INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Florida)

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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.995(a),
PARENTING PLAN (02/18)
When should this form be used?
A Parenting Plan is required in all cases involving time-sharing with minor child(ren), even when time-
sharing is not in dispute. The Parenting Plan must be developed and agreed to by the parents and
approved by the court. If the parties cannot agree to a Parenting Plan or if the parents agreed to a plan
that is not approved by the court, a Parenting Plan will be established by the court with or without the
use of parenting plan recommendations. This form or a similar form should be used in the development
of a Parenting Plan. If the case involves supervised time-sharing, the Supervised/Safety Focused
Parenting Plan, Florida Supreme Court Approved Family Law Form 12.995(b) or a similar form should be
used. If the case involves relocation, pursuant to Section 61.13001, Florida Statutes, then a
Relocation/Long Distance Parenting Plan, Florida Supreme Court Approved Family Law Form 12.995(c)
or a similar form should be used. The parents must identify a name or designation to be used
throughout this Parenting Plan.
This form should be typed or printed in black ink. Please either delete or strike-through terms or
paragraphs that are inappropriate or inapplicable to your agreement. If an agreement has been reached,
both parties must sign the Parenting Plan and have their signatures witnessed by a notary public or
deputy clerk. After completing this form, you should file the original with the clerk of the circuit court
in the county where the petition was filed and keep a copy for your records. You should then refer to
the instructions for your petition, answer, or answer and counterpetition concerning the procedures for
setting a hearing or trial (final hearing). If the parents have not reached an agreement, a proposed
Parenting Plan may be filed by either parent at the time of or any time prior to the final hearing. If an
agreed Parenting Plan is not filed by the parties, the court shall establish a Plan.
IMPORTANT INFORMATION REGARDING E-FILING
The Florida Rules of Judicial Administration now require that all petitions, pleadings, and documents be
filed electronically except in certain circumstances. Self-represented litigants may file petitions or other
pleadings or documents electronically; however, they are not required to do so. If you choose to file
your pleadings or other documents electronically, you must do so in accordance with Florida rule of
Judicial Administration 2.525, and you must follow the procedures of the judicial circuit in which you file.
The rules and procedures should be carefully read and followed.
IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION
After the initial service of process of the petition or supplemental petition by the Sheriff or certified
process server, the Florida Rules of Judicial Administration now require that all documents required or
permitted to be served on the other party must be served by electronic mail (e-mail) except in certain
Instructions for Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
circumstances. You must strictly comply with the format requirements set forth in the Rules of Judicial
Administration. If you elect to participate in electronic service, which means serving or receiving pleadings
by electronic mail (e-mail), or through the Florida Courts E-Filing Portal, you must review Florida Rule of
Judicial Administration 2.516. You may find this rule at www.flcourts.org through the link to the Rules of
Judicial Administration provided under either Family Law Forms: Getting Started, or Rules of Court in the
A-Z Topical Index.
SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT
REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by e-mail, the
procedures must always be followed once the initial election is made.
To serve and receive documents by e-mail, you must designate your e-mail addresses by using the
Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form
12.915, and you must provide your e-mail address on each form on which your signature appears. Please
CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme Court
Approved Family Law Form 12.914; Designation of Current Mailing and E-mail Address, Florida Supreme
Court Approved Family Law Form 12.915; and Florida Rule of Judicial Administration 2.516.
Where can I look for more information?
Before proceeding, you should read “General Information for Self-Represented Litigants” found at the
beginning of these forms. The words that are in “bold underline” in these instructions are defined
there. For further information, see chapter 61, Florida Statutes, and the instructions for the petition
and/or answer that were filed in this case.
Special notes...
At a minimum, the Parenting Plan must describe in adequate detail:
How the parties will share and be responsible for the daily tasks associated with the upbringing
of the child(ren),
The time-sharing schedule arrangements that specify the time that the minor child(ren) will
spend with each parent,
A designation of who will be responsible for any and all forms of health care, school-related
matters, including the address to be used for school-boundary determination and registration,
other activities, and
The methods and technologies that the parents will use to communicate with the child(ren).
The best interests of the child(ren) is the primary consideration in the Parenting Plan. In creating the
Parenting Plan, all circumstances between the parents, including their historic relationship, domestic
violence, and other factors must be taken into consideration. Determination of the best interests of the
child(ren) shall be made by evaluating all of the factors affecting the welfare and interest of the particular
minor child(ren) and the circumstances of that family, as listed in section 61.13(3), Florida Statutes,
including, but not limited to:
Instructions for Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
The demonstrated capacity and disposition of each parent to facilitate and encourage a close and
continuing parent-child relationship, to honor the time-sharing schedule, and to be reasonable
when changes are required;
The anticipated division of parental responsibilities after the litigation, including the extent to
which parental responsibilities will be delegated to third parties;
The demonstrated capacity and disposition of each parent to determine, consider, and act upon
the needs of the child(ren) as opposed to the needs or desires of the parent;
The length of time the child(ren) has lived in a stable, satisfactory environment and the desirability
of maintaining continuity;
The geographic viability of the parenting plan, with special attention paid to the needs of school-
age children and the amount of time to be spent traveling to effectuate the parenting plan. This
factor does not create a presumption for or against relocation of either parent with a child(ren);
The moral fitness of the parents;
The mental and physical health of the parents;
The home, school, and community record of the child(ren);
The reasonable preference of the child(ren), if the court deems the child(ren) to be of sufficient
intelligence, understanding, and experience to express a preference;
The demonstrated knowledge, capacity, and disposition of each parent to be informed of the
circumstances of the minor child(ren), including, but not limited to, the child(ren)’s friends,
teachers, medical care providers, daily activities, and favorite things;
The demonstrated capacity and disposition of each parent to provide a consistent routine for the
child(ren), such as discipline, and daily schedules for homework, meals, and bedtime;
The demonstrated capacity of each parent to communicate with and keep the other parent
informed of issues and activities regarding the minor child(ren), and the willingness of each parent
to adopt a unified front on all major issues when dealing with the child(ren);
Evidence of domestic violence, sexual violence, child abuse, child abandonment, or child neglect,
regardless of whether a prior or pending action relating to those issues has been brought. If the
court accepts evidence of prior or pending actions regarding domestic violence, sexual violence,
child abuse, child abandonment, or child neglect, the court must specifically acknowledge in
writing that such evidence was considered when evaluating the best interests of the child(ren);
Evidence that either parent has knowingly provided false information to the court regarding any
prior or pending action regarding domestic violence, sexual violence, child abuse, child
abandonment, or child neglect;
The particular parenting tasks customarily performed by each parent and the division or parental
responsibilities before the institution of litigation and during the pending litigation, including the
extent to which parenting responsibilities were undertaken by third parties;
The demonstrated capacity and disposition of each parent to participate and be involved in the
child(ren)’s school and extracurricular activities-
The demonstrated capacity and disposition of each parent to maintain an environment for the
child(ren) which is free from substance abuse;
The capacity and disposition of each parent to protect the child(ren) from the ongoing litigation
as demonstrated by not discussing the litigation with the child(ren), not sharing documents or
Instructions for Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
electronic media related to the litigation with the child(ren), and refraining from disparaging
comments about the other parent to the child)ren); and
The developmental stages and needs of the child(ren) and the demonstrated capacity and
disposition of each parent to meet the child(ren)’s developmental needs.
This standard form does not include every possible issue that may be relevant to the facts of your case.
The Parenting Plan should be as detailed as possible to address the time-sharing schedule. Additional
provisions should be added to address all of the relevant factors. The parties should give special
consideration to the age and needs of each child.
In developing the Parenting Plan, you may wish to consult or review other materials which are available
at your local library, law library or through national and state family organizations.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out
these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules
of Procedure Form 12.900 (a), before he or she helps you. A nonlawyer helping you fill out these forms
also must put his or her name, address, and telephone number on the bottom of the last page of every
form he or she helps you complete.
Instructions for Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
_______________________________
______________________________
IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT
IN AND FOR _________________ COUNTY, FLORIDA
Case No: _____________________
Division: _____________________
Petitioner,
and
Respondent.
PARENTING PLAN
This parenting plan is: {Choose only one}
_____A Parenting Plan submitted to the court with the agreement of the parties.
_____A proposed Parenting Plan submitted by or on behalf of:
{Parent’s Name}_______________________________________________.
_____A Parenting Plan established by the court.
This parenting plan is: {Choose only one}
_____A final Parenting Plan established by the court.
_____A temporary Parenting Plan established by the court.
_____A modification of a prior final Parenting Plan or prior final order.
I. PARENTS
Petitioner, hereinafter referred to in this Parenting Plan as Parent
{name or designation} ___________________________________________________
Name:__________________________________________________________________
Address: ________________________________________________________________
Telephone Number: __________________E-Mail: _______________________________
_____ Address Unknown: {Please indicate here if Petitioner’s address is unknown}
_____ Address Confidential: {Please indicate here if Petitioner’s address and phone numbers are
confidential pursuant to either a _____ Final Judgment for Protection Against Domestic Violence,
or _____ other court order ______________________________________}.
Respondent, hereinafter referred to in this Parenting Plan as Parent
{name or designation} _________________________________________________________
Name:__________________________________________________________________
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Address: ________________________________________________________________
Telephone Number: _________________ E-Mail: ________________________________
_____ Address Unknown: {Please indicate here if Respondent’s address is unknown}
_____ Address Confidential: {Please indicate here if Respondent’s address and phone numbers
are confidential pursuant to either a _____ Final Judgment for Protection Against Domestic
Violence or _____ other court order______________________________________.}
II. CHILDREN: This parenting plan is for the following child(ren) born to, or adopted by the parties: (add
additional lines as needed)
Name Date of Birth
III. JURISDICTION
The United States is the country of habitual residence of the child(ren).
The State of Florida is the child(ren)’s home state for the purposes of the Uniform Child Custody
Jurisdiction and Enforcement Act.
This Parenting Plan is a child custody determination for the purposes of the Uniform Child Custody
Jurisdiction and Enforcement Act, the International Child Abduction Remedies Act, 42 U.S.C. Sections
11601 et seq., the Parental Kidnapping Prevention Act, and the Convention on the Civil Aspects of
International Child Abduction enacted at the Hague on October 25, 1980, and for all other state and
federal laws.
Other: _________________________________________________________________________.
IV. PARENTAL RESPONSIBILITY AND DECISION MAKING
{Insert the name or designation of the appropriate parent in the space provided.}
1. Parental Responsibility {Choose only one}
a._____ Shared Parental Responsibility.
It is in the best interests of the child(ren) that the parents confer and jointly make all
major decisions affecting the welfare of the child(ren). Major decisions include, but are
not limited to, decisions about the child(ren)’s education, healthcare, and other
responsibilities unique to this family. Either parent may consent to mental health
treatment for the child(ren).
OR
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
b._____ Shared Parental Responsibility with Decision Making Authority
It is in the best interests of the child(ren) that the parents confer and attempt to agree on
the major decisions involving the child(ren). If the parents are unable to agree, the
authority for making major decisions regarding the child(ren) shall be as follows:
Education/Academic decisions Parent ______________
Non-emergency health care Parent ______________
Other: {Specify}______________ Parent ________________
___________________________ Parent ________________
___________________________ Parent _______________
OR
c._____ Sole Parental Responsibility:
It is in the best interests of the child(ren) that Parent {name or designation}
____________________ shall have sole authority to make major decisions for the
child(ren.) It is detrimental to the child(ren) to have shared parental responsibility.
2. Day-to-Day Decisions
Unless otherwise specified in this plan, each parent shall make decisions regarding day-to-
day care and control of each child while the child is with that parent. Regardless of the
allocation of decision making in the parenting plan, either parent may make emergency
decisions affecting the health or safety of the child(ren) when the child is residing with that
parent. A parent who makes an emergency decision shall share the decision with the other
parent as soon as reasonably possible.
3. Extra-curricular Activities {Indicate all that apply}
{Insert the name or designation of the appropriate parent in the space provided.
a._____Either parent may register the child(ren) and allow them to participate in the activity
of the child(ren)’s choice.
b._____The parents must mutually agree to all extra-curricular activities.
c._____The parent with the minor child(ren) shall transport the minor child(ren) to and/or
from all mutually agreed upon extra-curricular activities, providing all necessary
uniforms and equipment within the parent’s possession.
d._____ The costs of the extra-curricular activities shall be paid by:
Parent __________________ ______%
Parent __________________ ________ %
e._____ The uniforms and equipment required for the extra-curricular activities shall be paid
by:
Parent __________________ _______ %
Parent __________________ ________%
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
f._____ Other: {Specify}_____________________________________________________
_______________________________________________________________.
V. INFORMATION SHARING. Unless otherwise indicated or ordered by the Court:
Unless otherwise prohibited by law, each parent shall have access to medical and school records
and information pertaining to the child(ren) and shall be permitted to independently consult
with any and all professionals involved with the child(ren). The parents shall cooperate with
each other in sharing information related to the health, education, and welfare of the child(ren)
and they shall sign any necessary documentation ensuring that both parents have access to said
records.
Each parent shall be responsible for obtaining records and reports directly from the school and
health care providers.
Both parents have equal rights to inspect and receive governmental agency and law
enforcement records concerning the child(ren).
Both parents shall have equal and independent authority to confer with the child(ren)’s
school, day care, health care providers, and other programs with regard to the child(ren)’s
educational, emotional, and social progress.
Both parents shall be listed as “emergency contacts” for the child(ren).
Each parent has a continuing responsibility to provide a residential, mailing, and contact address
and contact telephone number to the other parent. Each parent shall notify the other parent in
writing within 24 hours of any changes. Each parent shall notify the court in writing within seven
(7) days of any changes.
Other: _________________________________________________________________
________________________________________________________________.
VI. SCHEDULING
1. School Calendar
If necessary, on or before ______________ of each year, both parents should obtain a
copy of the school calendar for the next school year. The parents shall discuss the
calendars and the time-sharing schedule so that any differences or questions can be
resolved.
The parents shall follow the school calendar of: {Indicate all that apply}
a._____the oldest child
b._____the youngest child
c.______________________ County
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
___________________________________________________________________
___________________________________________________________________
d.______________________ School
2. Academic Break Definition
When defining academic break periods, the period shall begin at the end of the last
scheduled day of classes before the holiday or break and shall end on the first day of
regularly scheduled classes after the holiday or break.
3. Schedule Changes {Indicate all that apply}
a._____ A parent making a request for a schedule change will make the request as soon
as possible, but in any event, except in cases of emergency, no less than _____________
__________________before the change is to occur.
b._____ A parent requesting a change of schedule shall be responsible for any additional
child care, or transportation costs caused by the change.
c._____ Other {Specify}____________________________________________________.
VII. TIME-SHARING SCHEDULE
{Insert the name or designation of the appropriate parent in the space provided.}
{A time-sharing schedule must be provided for both parents.}
1. Weekday and Weekend Schedule
The following schedule shall apply beginning on ________________________ with
Parent {name or designation}_________________________ and continue as follows:
The child(ren) shall spend time with Parent _______________ on the following dates
and times:
WEEKENDS: _____ Every _____ Every Other _____ Other {specify} _____________
From____________________________ to _________________________________
WEEKDAYS: {Specify days} ______________________________________________
From _____________________________ to _______________________________
OTHER: {Specify} _____________________________________________________
___________________________________________________________________.
The child(ren) shall spend time with the Parent _______________ on the following
dates and times:
WEEKENDS: _____ Every _____ Every Other _____ Other {specify}______________
From____________________________ to _________________________________
WEEKDAYS: {Specify days} ______________________________________________
From _____________________________ to _______________________________
OTHER: {Specify} _____________________________________________________
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
2.
___________________________________________________________________.
Please indicate if there is a different time sharing schedule for any child. Complete a
separate Attachment for each child for whom there is a different time sharing
schedule.
_____ There is a different time-sharing schedule for the following child(ren) in
Attachment _________.
_____________________________, and _________________________.
(Name of Child) (Name of Child)
Holiday Schedule {Choose only one}
a. _____No holiday time sharing shall apply. The regular time-sharing schedule set forth
above shall apply.
b. _____Holiday time-sharing shall be as the parties agree.
c. _____Holiday time-sharing shall be in accordance with the following schedule. The
Holiday schedule will take priority over the regular weekday, weekend, and summer
schedules. Fill in the blanks with the name or designation of the appropriate parent to
indicate where the child(ren) will be for the holidays. Provide the beginning and ending
times. If a holiday is not specified as even, odd, or every year with one parent, then the
child(ren) will remain with the parent in accordance with the regular schedule
Holidays Even Years Odd Years Every Year Begin/End Time
Mother’s Day __________ _________ __________ _____________
Father’s Day __________ _________ __________ _____________
President’s Day __________ _________ __________ _____________
M. L. King Day __________ _________ __________ _____________
Easter __________ _________ __________ _____________
Passover __________ _________ __________ _____________
Memorial Day Wkd _______ __________ __________ _____________
4
th
of July __________ _________ __________ _____________
Labor Day Wkd __________ _________ __________ _____________
Columbus Day Wkd _______ _________ __________ _____________
Halloween __________ _________ __________ _____________
Thanksgiving __________ _________ __________ _____________
Veteran’s Day __________ _________ __________ _____________
Hanukkah __________ _________ __________ _____________
Yom Kippur __________ _________ __________ _____________
Rosh Hashanah __________ _________ __________ _____________
Child(ren)’s
Birthdays: __________ _________ __________ _____________
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
__________ __________ _________ __________ _____________
__________ __________ _________ __________ _____________
_______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
This holiday schedule may affect the regular Time-Sharing Schedule. Parents may wish to
specify either or both of the following options:
d._____When the parents are using an alternating weekend plan and the holiday
schedule would result in one parent having the child(ren) for three weekends in a row,
the parents will exchange the following weekend, so that each has two weekends in a
row before the regular alternating weekend pattern resumes.
e._____If a parent has the child(ren) on a weekend immediately before or after an
unspecified holiday or non-school day, they shall have the child(ren) for the holiday or
non-school day.
3. Winter Break {Choose only one}
{Insert the name or designation of the appropriate parent in the space provided.}
a. _____Parent__________________ shall have the child(ren) from the day and time
school is dismissed until December ____________ at ______ a.m./p. m in ____odd-
numbered years _____ even-numbered years ____ every year. The other parent will
have the children for the second portion of the Winter Break. The parties shall alternate
the arrangement each year.
b._____ Parent ______________________ shall have the child(ren) for the entire
Winter Break during _____ odd-numbered years _____ even-numbered years _____
every year.
c._____Other: ___________________________________________________________
_______________________________________________________________________.
d. _____Specific Winter Holidays
If not addressed above, the specific Winter Holidays such as Christmas, New Year’s Eve,
Hanukkah, Kwanzaa, etc. shall be shared as follows:
______________________________________________________________________.
4. Spring Break {Choose only one}
{Insert the name or designation of the appropriate parent in the space provided.}
a. _____ The parents shall follow the regular schedule.
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
b. _____The parents shall alternate the entire Spring Break with Parent
________________having the child(ren) during the _____odd-numbered years
and Parent _______________ during the _____even numbered years.
c._____Parent _______________ _____ Parent ________________ shall have the
child(ren) for the entire Spring Break every year.
d._____The Spring Break will be evenly divided. The first half of the Spring Break will go
to the parent whose regularly scheduled weekend falls on the first half and the second
half going to the parent whose weekend falls during the second half.
e._____Other: {Specify}_______________________________________.
5. Summer Break {Choose only one}
{Insert the name or designation of the appropriate parent in the space provided.}
a. _____The parents shall follow the regular schedule through the summer.
b._____ Parent _________________ shall have the entire Summer Break from
______________after school is out until _______________ before school starts.
C ._____The parents shall equally divide the Summer Break as follows:
During _____ odd-numbered years_____ even numbered years, _____Parent _______
_______ _____ Parent ______________ shall have the children from _____________
after school is out until _____________. The other parent shall have the child(ren) for
the second one-half of the Summer Break. The parents shall alternate the first and
second one-halves each year unless otherwise agreed. During the extended periods of
time-sharing, the other parent shall have the child(ren) ________________________
______________________________________________________________________.
d._____Other: {Specify}____________________________________________________
_______________________________________________________________________.
6. Number of Overnights:
{Insert the name or designation of the appropriate parent in the space provided.}
Based upon the time-sharing schedule, Parent ________________ has a total of _____
overnights per year and Parent ________________ has a total of _____ overnights per
year.
Note: The two numbers must equal 365.
7. _____If not set forth above, the parties shall have time-sharing in accordance with the
schedule which is attached and incorporated herein.
VIII. TRANSPORTATION AND EXCHANGE OF CHILD(REN)
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
{Insert the name or designation of the appropriate parent in the space provided.}
1.
2.
3.
Transportation {Choose only one}
a.____ Parent ______________ shall provide all transportation.
b. _____The parent beginning their time-sharing shall provide transportation for the
child(ren).
c._____The parent ending their time-sharing shall provide transportation for the
child(ren).
d._____Other: {Specify}___________________________________________________
_____________________________________________________________________.
Exchange
Both parents shall have the child(ren) ready on time with sufficient clothing packed
and ready at the agreed upon time of exchange. If a parent is more than ________
minutes late without contacting the other parent to make other arrangements, the
parent with the child(ren) may proceed with other plans and activities.
{Choose only one}:
a. _____Exchanges shall be at the parents’ homes unless both parents agree to a
different meeting place.
b. _____Exchanges shall occur at __________________________________________
____________________________________________________________ unless both
parties agree in advance to a different meeting place.
c. _____Other: _______________________________________________________.
Transportation Costs {Choose only one}
{Insert the name or designation of the appropriate parent in the space provided.}
a. _____Transportation costs are included in the Child Support Worksheets and/or the
Order for Child Support and should not be included here.
b._____Parent _____________ shall pay ______% and Parent __________________
shall pay ______ % of the transportation costs.
c. _____Other: ___________________________________________________________.
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
_____________________________________________________________________
_____________________________________________________________________
____________________________________________________________________
4. Foreign and Out-Of-State Travel {Indicate all that apply}
a. _____Either parent may travel within the United States with the child(ren) during
his/her time-sharing. The parent traveling with the child(ren) shall give the other parent
at least ____ days written notice before traveling out of state unless there is an
emergency, and shall provide the other parent with a detailed itinerary, including
locations and telephone numbers where the child(ren) and parent can be reached at
least ____ days before traveling.
b. _____Either parent may travel out of the country with the child(ren) during his/her
time-sharing. At least ___ days prior to traveling, the parent shall provide a detailed
itinerary, including locations, and telephone numbers where the child(ren) and parent
may be reached during the trip. Each parent agrees to provide whatever
documentation is necessary for the other parent to take the child(ren) out of the
country.
c. _____If a parent wishes to travel out of the country with the child(ren), he/she shall
provide the following security for the return of the child
_____________________________________________________________________.
d. _____Other _________________________________________________________.
IX. EDUCATION
1. School designation.
For purposes of school boundary determination and registration, the address of
Parent {name or designation} _______________________ shall be used .
2. _____ {If Applicable} The following provisions are made regarding private or home
schooling: ___________________________________________________________
_____________________________________________________________________.
3. Other. ________________________________________________________________
____________________________________________________________________.
X. DESIGNATION FOR OTHER LEGAL PURPOSES
{Insert the name or designation of the appropriate parent in the space provided.}
The child(ren) named in this Parenting Plan are scheduled to reside the majority of the time with
Parent __________________ . This majority designation is SOLELY for purposes of all other state
and federal laws which require such a designation. This designation does not affect either
parent’s rights and responsibilities under this Parenting Plan.
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
_____________________________________________________________________
_____________________________________________________________________
XI. COMMUNICATION
1. Between Parents
All communications regarding the child(ren) shall be between the parents. The parents
shall not use the child(ren) as messengers to convey information, ask questions, or set
up schedule changes.
The parents shall communicate with each other: {Indicate all that apply}
_____in person
_____by telephone
_____by letter
_____by e-mail
_____Other: {Specify}_________________________________________.
2. Between Parent and Child(ren)
Both parents shall keep contact information current. Telephone or other electronic
communication between the child(ren) and the other parent shall not be monitored by or
interrupted by the other parent. “Electronic communication” includes telephones,
electronic mail or e-mail, webcams, video-conferencing equipment and software or other
wired or wireless technologies or other means of communication to supplement face to face
contact.
The child(ren) may have _____ telephone _____ e-mail _____ other electronic
communication in the form of _______________________________ with the other parent:
{Choose only one}
a. _____Anytime
b. _____Every day during the hours of ________ to ___________.
c. _____On the following days_____________________________________________
during the hours of ____________ to ____________.
d. _____Other: _________________________________________________________.
3. Costs of Electronic Communication shall be addressed as follows:
_____________________________________________________________________.
XII. CHILD CARE {Choose only one}
1. _____Each parent may select appropriate child care providers
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2. _____All child care providers must be agreed upon by both parents.
3. _____Each parent must offer the other parent the opportunity to care for the child(ren)
before using a child care provider for any period exceeding _______ hours.
4. _____Other: {Specify}__________________________________________________.
XIII. CHANGES OR MODIFICATIONS OF THE PARENTING PLAN
Temporary changes to this Parenting Plan may be made informally without a written document;
however, if the parties dispute the change, the Parenting Plan shall remain in effect until further
order of the court.
Any substantial changes to the Parenting Plan must be sought through the filing of a
supplemental petition for modification.
XIV. RELOCATION
Any relocation of the child(ren) is subject to and must be sought in compliance with section
61.13001, Florida Statutes.
XV. DISPUTES OR CONFLICT RESOLUTION
Parents shall attempt to cooperatively resolve any disputes which may arise over the terms of
the Parenting Plan. The parents may wish to use mediation or other dispute resolution methods
and assistance, such as Parenting Coordinators and Parenting Counselors, before filing a court
action.
XVI. OTHER PROVISIONS
___________________________________________________________________________.
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
_______________________________________
_______________________________________
_____________________________
SIGNATURES OF PARENTS
I certify that I have been open and honest in entering into this Parenting Plan. I am satisfied with this
Plan and intend to be bound by it.
Dated:
STATE OF FLORIDA
COUNTY OF _________________________
Sworn to or affirmed and signed before me on
__ Personally known
__ Produced identification
Type of identification produced
Signature of Petitioner/Parent ______________
Printed Name: ___________________________
Address:
City, State, Zip:
Telephone Number:
Fax Number:
Designated E-mail Address(es):______________
by .
NOTARY PUBLIC or DEPUTY CLERK
{Print, type, or stamp commissioned name of
notary or clerk.}
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
_______________________________________
____________________________________
I certify that I have been open and honest in entering into this Parenting Plan. I am satisfied with this
Plan and intend to be bound by it.
Dated:________________________
STATE OF FLORIDA
COUNTY OF _________________________
Sworn to or affirmed and signed before me on
Signature of Respondent/Parent ____________
Printed Name: ___________________________
Address:
City, State, Zip:
Telephone Number:
Fax Number:
Designated E-mail Address(es):____________
by .
NOTARY PUBLIC or DEPUTY CLERK
__ Personally known
__Produced identification
{Print, type, or
notary or clerk.}
stamp commissioned name of
Type of identification produced ____________________________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:
[fill in all blanks] This form was prepared for the: {choose only one} _____ Petitioner
_____ Respondent
This form was completed with the assistance of:
{name of individual} ________________________________________________________________,
{name of business} _________________________________________________________________,
{address} _________________________________________________________________________,
{city} _________________, {state} ______, {zip code} _________, {telephone number} ____________.
Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (02/18)
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FORM 12.995(a),: INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Florida)

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Completed 15 February 2021

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