COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. :
: JOINT LEGAL CUSTODY ATTACHMENT JUDICIAL Plaintiff(s)
TO Petition or Application for Order
Findings and Order After Hearing or Judgment
Stipulation and Order for Custody and/or Visitation of Children 1. The parents will have joint legal custody of the minor children.
2. In exercising joint legal custody, the parents will share in the responsibility and confer in good faith on matters concerning the health, : education, and welfare of the children. The parents must confer in making decisions on the following matters: Enrollment in or leaving a particular private or public school or daycare center Defendant(s) : . . . . . Participation in. particular. religious .activities or institutions . . . . . . . . .......... ...... ...... ................ b. a. c. d. e. f. g. Beginning or ending of psychiatric, psychological, or other mental health counseling or therapy Selection of a doctor, dentist, or other health professional (except in emergency situations) Participation in extracurricular activities THE PEOPLE OF THE STATE OF NEW YORK Out-of-country or out-of-state travel
TO Other (specify):
In all other matters in exercising joint legal custody, the parents may act alone, as long as the action does not conflict with any orders concerning the physical custody of the children. 3. If a parent does not obtain the required consent of the other parent to the decisions checked in item 2: the Honorable at the Court a. He or she may be subject to civil or criminal penalties. located at County of change the legal and physical custody of the minor children. b. The court may , on the , 20 , at o'clock in the Other consequences (specify):day of c. in room 4. Special decision-making designation
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before ,
noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the
a. The petitioner respondent will be responsible for making decisions regarding the following issues (specify): to comply with this subpoena is punishable as a contempt of court and will make you Your failure
liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure towill have access to the children's school, medical, and dental records and the right to consult with b. Each parent comply.
professionals who are providing services to the children. 5.
Witness, Honorable Health-care notification Court in County,
, one of the Justices of the day of , 20
Each parent must notify the other of the name and address of each health practitioner who examines or treats the children; such notification must be made within (specify number): days of the commencement of the first such treatment or examination. (Attorney must sign health and welfare of the Each parent is authorized to take any and all actions necessary to protect theabove and type name below) children, including but not limited to consent to emergency surgical procedures or treatment. The parent authorizing such emergency treatment must notify the other parent as soon as possible of the emergency situation and of all procedures or treatment administered to the children.
c. 6. 7. 8.
Both parents are required to administer any prescribed medications for the children.
School notification. Each parent will be designated as a person the children's school will contact in the event of an emergency. Name. Neither parent will change the last name of the children or have a different name used on the children's medical, Office and P.O. Address school, or other records without the written consent of the other parent. Other (specify):
Form Approved for Optional Use Judicial Council of California FL-341(E) [Rev. January 1, 2005]
Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. JOINT LEGAL CUSTODY ATTACHMENT No.:
Page 1 of 1 Family Code, § 3003, 3083 www.courtinfo.ca.gov
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