5.2 Parenting Plan Worksheet

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This parenting plan worksheet can help you and the other parent spell out the details of how you are going to parent. If you and the other parent develop a parenting plan, each of you should keep a copy.

Use the blank spaces below to type your responses. Once finished, you'll be able to print or save the document to your computer.

 

  • Parent:

 

  • Parent:
 

In the spaces provided below, give the full names and date of birth of each child. If any of your children have a different parent, indicate this after their name. 

 

Name of any other person with an interest in and relationship to child, e.g. grandparent, separated parent.

 
  • 1. Parenting goals
 
  • 2. Communication Ground Rules 
 
  • 3. Parenting Time Arrangements (list all options)

    • Week-to-week arrangements

    • Vacation times

    • Holidays

    • Special days (birthdays)

    • Special occasions (weddings, funerals, graduation)

    • School sports, church, and community events (parent-teacher conferences)

 
  • 4. Transportation Details

    • Transportation responsibilities, exchange times and places

    • Special instructions or restrictions 

 
  • 5. Telephone Schedule

    • When children are with Mom

    • When children are with Dad

 
  • 6. Long-distance parenting arrangements (if a parent lives more than 100 km away)

    • Yearly time-sharing schedule

    • Transportation details (including costs)

    • How information will be shared 

 
  • 7. Procedures for Making Decisions

    • How decisions will be made and by whom (education, day care, medical, culture and spiritual upbringing)?

    • Who will give (non-medical) consents for the child? 

    • Who will apply for a passport, license, permits and other benefits and privileges on behalf of the child? 

    • How will disagreements be resolved? 

 
  • 8. Procedures for Sharing Information

    • School-related information (report cards, disciplinary problems, school activities) 

    • Extracurricular activities

    • Health-related information (illnesses, checkups, prescriptions)

    • Community and special events 

 
  • 9. Agenda for a Parenting Meeting (on a monthly or weekly basis)
     
     
     
     
     
 
  • 10. Child Support

    • Amount (determined by the Child Support Guidelines) 

 
  • 11. Post-secondary Education 

    • Carried by whom? 

    • Contributions by parents

    • Financial planning options

 
  • 12. Health Insurance

    • Carried by whom? 

    • Procedure for making claims

 
 
http://howtoseparate.ca/5-reaching-agreement/51-creating-agreements
http://howtoseparate.ca/5-reaching-agreement/53-separation-agreement
5.2 Parenting Plan Worksheet