Suggested Wording For Orders Or Agreements For Supervised Access

Suggested Wording For Orders Or Agreements For Supervised Access

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Suggested Wording for Orders or Agreements for Supervised Access –
Visits and Exchanges
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(Use this document along with the document “Information for Court
Orders or Agreements”)
Supervised Visits
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The  applicant /  respondent (insert name) _______________________
shall have supervised visits with:
 the children named in this order.
 the following child(ren):
Full legal Name
Birthdate (d,m,y)
Day Month Year
The supervised visits shall be supervised by:
 the supervised access centre agreed to by the parties
 the following supervised access centre (insert name of access
centre) _______________________________________________
 other (specify) ____________________________________________
subject to the agreement of the supervised access provider.
The supervised visits shall take place as follows.
 ______ visit(s) of ______hour(s) duration, every ______ week(s) on
such days and times as the supervised access provider is available and
in accordance with the supervised access centre policy,
 The  applicant /  respondent shall remain at the supervised access
centre with the child(ren) for the entire visit,
 The  applicant /  respondent shall remain at the supervised access
centre with the child(ren) for the first __________ and the last
__________ of the visit and may otherwise remove the child(ren) from
the access centre.
 Only the  applicant /  respondent may attend visits at the
supervised access centre, unless otherwise agreed between the
applicant and the respondent and in accordance with the supervised
access centre policy.
 The following other adult(s)/child(ren) may attend visits with the 
applicant /  respondent at the supervised access centre, subject to
the agreement of the supervised access provider.
Full legal Name
Birthdate (d,m,y)
Day Month Year
Supervised Exchanges
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Supervised exchanges of the child(ren) for the purpose of access
visits with the
 applicant /  respondent (insert name) _______________________ shall
 occur as required in order to facilitate the access schedule set out
in the order of the Honourable __________________________, dated
__________________,
and shall be supervised by:
 the supervised access centre agreed to by the parties
 the following supervised access centre (name of access centre)
__________________________________________________
 other (specify) ____________________________________________
subject to the agreement of the supervised access provider.
 occur as required in order to facilitate the following access
schedule:
______ visit(s) of ______hour(s) duration, every ______ week(s),
between the
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applicant /  respondent (insert name) _______________________ and
 the children named in this order.
 the following child(ren):
Full legal Name
Birthdate (d,m,y)
Day Month Year
and shall be supervised by:
 the supervised access centre agreed to by the parties
 the following supervised access centre (name of access centre)
________________________________________________
 other (specify) ____________________________________________
subject to the agreement of the supervised access provider.
Other Issues
 The applicant and the respondent shall each contact the supervised
access centre within ______ days of this order to arrange an intake
interview and complete any documents that are required in order for
the visits or exchanges to occur within ____ days of their intake
interview.
 The costs incurred for supervised visits or exchanges shall
 be apportioned in accordance with the policies of the supervised
access centre.
 be apportioned ______ per cent by the applicant, and ______ per cent
by the respondent.
 Other costs for (specify-e.g. reports, interpreters)
_____________________ incurred in connection with the supervised
visits/exchanges shall
 be apportioned in accordance with the policies of the supervised
access centre.
 be apportioned ______ per cent by the applicant, and ______ per cent
by the respondent.
Duration of Order
This order is made on a:
 temporary basis and is adjourned to (insert date)
____________________ for review.
 final basis.
Other Considerations
 This court further orders that (specify- include here any
requirements concerning photos, food, gifts, activities, child car
restraints etc.)
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