California > Judicial Council > Family Law - Motions
Supervised Visitation Order FL-341(A) - California
|Supervised Visitation Order Form. This is a California form and can be used in Family Law - Motions Judicial Council .||
|Get this form for FREE as a print-only pdf|
FL-341(A) PETITIONER / PLAINTIFF: RESPONDENT / DEFENDANT: CASE NUMBER: SUPERVISED VISITATION ORDER Attachment to Child Custody and Visitation Order Attachment (form FL-341) 1. Evidence has been presented in support of a request that the contact of be supervised based upon allegations of abduction of child(ren) physical abuse drug abuse sexual abuse domestic violence alcohol abuse Respondent Petitioner investigation and hearing or trial. Petitioner Respondent with the child(ren) neglect other (specify): disputes these allegations and the court reserves the findings on these issues pending further 2. The court finds, under Family Code section 3100, that the best interest of the child(ren) requires that visitation by Respondent must, until further order of the court, be limited to contact supervised by the person(s) set Petitioner forth in item 6 below pending further investigation and hearing or trial. THE COURT MAKES THE FOLLOWING ORDERS 3. CHILD(REN) TO BE SUPERVISED Birth date Child's name Age Sex 4. TYPE a. Supervised visitation b. Supervised exchange only c. Therapeutic visitation 5. SUPERVISED VISITATION PROVIDER a. Professional (individual provider or supervised visitation center) 6. AUTHORIZED PROVIDER Name b. Nonprofessional Address Telephone Any other mutually agreed-upon third party as arranged. 7. DURATION AND FREQUENCY OF VISITS (see form FL-341 for specifics of visitation): 8. PAYMENT RESPONSIBILITY 9. Petitioner: ______% Respondent: ______% Petitioner will contact professional provider or supervised visitation center no later than (date): Respondent will contact professional provider or supervised visitation center no later than (date): 10. THE COURT FURTHER ORDERS Date: JUDICIAL OFFICER Page 1 of 1 Form Adopted for Mandatory Use Judicial Council of California FL-341(A) [Rev. January 1, 2003] SUPERVISED VISITATION ORDER Family Code, §§ 3100, 3031 www.courtinfo.ca.gov 2003 © American LegalNet, Inc.