LIVE CHAT

Child Questionnaire

    First Name:
    Last Name:
    Phone:
    Email:
    City:
    State:
    Zip:
    Rights and Duties Each has
    at all
    times    		 Each has
    during
    possession    		 Solely Mother Solely Father Each has independently Each has
    by
    agreement    		 Consultation with other Conservator Required Proposed
    or Agreed
    Duty to inform the other parent in a timely manner of significant information concerning the health, education, and welfare of the child Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Duty to inform the other parent if the parent resides with for at least thirty days, marries, or intends to marry a person the parent knows is a registered sex offender or is currently charged with an offense that would require registration on conviction Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to receive information from the other parent concerning the health, education, and welfare of the child Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to confer with the other parent, to the extent possible, before making a decision concerning the health, education, and welfare of the child Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to consult with a physician, Dentist, or psychologist of the child and have access to medical records Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to consult with the school officials concerning the child’s welfare and educational status, including school activities and access to educational records Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to attend school activities Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to be designated on the child’s records as a person to be notified in case of an emergency Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to consent to medical, dental, and surgical treatment during an emergency involving immediate danger to the health and safety of the child Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to manage the child’s estate to the extent the estate has been created by the parent or the parent’s family Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Duty of care, control, protection, and reasonable discipline of the child Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Duty to support the child, including providing the child with clothing, food, shelter, and medical and dental care not involving an invasive procedure Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to consent for the child to medical and dental care not involving an invasive procedure Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to direct the moral and religious training of the child Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Duty to make periodic child-support payments to the other conservator Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to establish the primary residence of the child Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to consent to medical, dental, and surgical treatment involving invasive procedures and to psychiatric and psychological treatment Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to represent the child in legal action and to make other decisions of substantial legal significance concerning the child Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to consent to marriage and enlistment in armed services of U.S. Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to make decisions concerning the child’s education Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to services and earnings of the child, except as provided by section 264.0111 of the Texas Family Code (state custody or foster care) Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Except when a guardian of the child’s estate or a guardian or attorney ad litem has been appointed for the child, the right to act as an agent of the child in relation to the child’s estate if the child’s action is required by a state, the U.S., or a foreign government Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Duty to manage the child’s estate to the extent the estate has been created by community property or the joint property of the parents Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right to Apply for Passport Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Right and duty to prepare and file income tax returns for the child’s estate Each has at all times Each has during possession Solely Mother Solely Father Each has independently Each has by agreement Consultation with other Conservator Required ProposedAgreed
    Please fill out what you desire for the following:
    Geographic Residency Restriction (Select)

    County of Residency
    School District
    Miles

    AgreedProposed

    School District or Private School:
    Does Visitation need to be supervised or restricted? Explain.
    Visitation Schedule Proposed or Agreed
    Standard Visitation Schedule (During School Term 1st, 3rd and 5th Friday at 6:00 p.m. to following Sunday at 6:00 p.m. During School Term every Thursday night from 6:00 p.m. to 8:00 p.m. Standard Holiday Schedule. Thirty days in the summer)
    Expanded Standard Visitation Schedule (Same as above except pick up at school on every Thursday and return to school every Friday. On 1st, 3rd and 5th weekends pick up at school on Friday and return to school on Monday.)
    One week on one week off schedule exchanges begins on day of the week at time.
    Different schedule as stated below (fill in Mother or Father on each day with times)
    Week Sunday Monday Tuesday Wednesday Thursday Friday Saturday
    1
    2
    3
    4

    Child Support Agreed $ or by guidelines based on $ income of paying parent.
    Who carries medical insurance currently? How much is insurance for children only?
    Please list any other concerns.