Pennsylvania Consolidated & Unconsolidated Statutes
Chapter 53 - Child Custody
Section 5331 - Parenting plan

(a) Purpose.--In a contested custody proceeding, the court may require the parties to submit parenting plans for the care and custody of the child to aid the court in resolving the custody dispute. A parenting plan and the position of a party as set forth in that parenting plan shall not be admissible as evidence by another party.
(b) Contents.--A parenting plan shall include the following:
(1) The schedule for personal care and control of the child, including parenting time, holidays and vacations.
(2) The education and religious involvement, if any, of the child.
(3) The health care of the child.
(4) Child-care arrangements.
(5) Transportation arrangements.
(6) A procedure by which proposed changes, disputes and alleged breaches of the custody order may be adjudicated or otherwise resolved through mediation, arbitration or other means.
(7) Any matter specified by the court.
(8) Any other matter that serves the best interest of the child.
(c) Form.--If the court orders the parties to propose a parenting plan, it shall be submitted to the court in substantially the following form:
CAPTION
PARENTING PLAN
This parenting plan involves the following child/children:
Child's Name
Age
Where does this child live?
1...................
..............
...........................
2...................
..............
...........................
3...................
..............
...........................
If you have children not addressed by this parenting plan, name here:
Child's Name
Age
Where does this child live?
1...................
..............
...........................
2...................
..............
...........................
3...................
..............
...........................
Legal Custody (who makes decisions about certain things):
Circle one
Diet.......... Both parties decide together / Plaintiff / Defendant
Religion....... Both parties decide together / Plaintiff / Defendant
Medical Care... Both parties decide together / Plaintiff / Defendant
Mental Health Care... Both parties decide together / Plaintiff / Defendant
Discipline..... Both parents decide together / Plaintiff / Defendant
Choice of School.... Both parents decide together / Plaintiff / Defendant
Choice of Study..... Both parents decide together / Plaintiff / Defendant
School Activities... Both parents decide together / Plaintiff / Defendant
Sports Activities... Both parents decide together / Plaintiff / Defendant
Additional Items... Both parents decide together / Plaintiff / Defendant
Explain what process you will use to make decisions?
(For example, the parent confronted with or anticipating the choice will call the other parent when the choice presents itself, and the other parent must agree or disagree within 24 hours of any deadline)
...............................................................
...............................................................
Physical Custody (where the child/children live)
The child's/children's residence is with........................
Describe which days and which times of the day the child/children will be with each person:
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
........................................................
Describe where and when the child/children will be dropped off and/or picked up (day and time of day)?
Drop-Off
Where...................................................
When....................................................
........................................................
Pick-Up
Where ...................................................
When ....................................................
.........................................................
If one of you doesn't show up, how long will the other wait?.......................................................
If there are any extraordinary costs (taxi, train, airplane, etc.), who will pay for which costs?
...........................................................
...........................................................
HOLIDAYS
Where will the child/children stay?
HOLIDAY
YEAR A
YEAR B
EVERY YEAR
Martin Luther King Day
..........
..........
...........
President's Day
..........
..........
...........
Easter
..........
..........
...........
Memorial Day
..........
..........
...........
Fourth of July
..........
..........
...........
Labor Day
..........
..........
...........
Yom Kippur
..........
..........
...........
Rosh Hashanah
..........
..........
...........
Thanksgiving
..........
..........
...........
Vacation after Thanksgiving
..........
..........
...........
Christmas Vacation
..........
..........
...........
Kwanzaa
..........
..........
...........
New Year's Eve/Day
..........
..........
...........
Spring Vacation
..........
..........
...........
Easter Sunday
..........
..........
...........
Child's Birthday
..........
..........
...........
Mother's Day
..........
..........
...........
Father's Day
..........
..........
...........
Other
..........
..........
...........
Other
..........
..........
...........
Other
..........
..........
...........
Summer Vacation Plans
.............................................................
.............................................................
Special Activities or School Activities

Will both of you attend?
Child's Name
Activity
If not, which of you will attend?
.................
..........
..................................
.................
..........
..................................
.................
..........
..................................
Temporary changes to this parenting schedule
From time to time, one of you might want or need to rearrange the parenting time schedule due to work, family or other events. You can attempt to agree on these changes. If you cannot agree, the parent receiving the request will make the final decision.
The parent asking for the change will ask......in person........by letter/mail.....by phone
No later than
....12 hours..... 24 hours.... 1 week..... 1 month
The parent being asked for a change will reply
.... in person..... by letter/mail..... by phone
No later than
..... 12 hours....... 24 hours........ 1 week....... 1 month
May parents contact one another?..............................
When the child/children is/are with one of you, how may they contact the other parent?.......................................
................................................................
When and how may .............................contact the child?
................................................................
................................................................
In the event that proposed changes, disputes or alleged breaches of this parenting plan and custody order are necessary or desired, the parties agree that such changes will be addressed by the following method (specify method of arbitration, mediation, court action, etc.):
................................................................
................................................................
The following matter or matters as specified by the court:
................................................................
................................................................
Other (Anything else you want to agree on):
................................................................
................................................................
................................................................
Date...........................
................................

Signature of Mother
Date...........................
................................

Signature of Father
Date...........................
................................

Signature of Witness