Child Custody Agreement

CONNECTICUT CUSTODY AGREEMENT AND PARENTING PLAN WORKSHEET

Use this worksheet to prepare current Judicial Branch Form JD-FM-284 or a
reviewed attachment. Do not file this worksheet in place of an official form
or treat a signed private plan as a custody order.

1. Select the Court Route

• ☐ Temporary agreement in a pending case. The requested terms apply only
  if and as approved by the Superior Court and remain subject to later orders.

• ☐ Final agreement. Submit the completed custody and parenting terms for
  the court's independent review and incorporation into a final order.

• ☐ Post-judgment agreed modification. Identify the existing order and use
  the current modification and agreement procedure. The prior order controls
  until the court enters a new order.

• ☐ New custody/visitation case between parents living separately. Use the
  current Judicial Branch filing packet, including JD-FM-161, JD-FM-162,
  JD-FM-158, JD-FM-164, and the required appearance and service documents.

• ☐ Contested matter. Use this worksheet only as a proposed parental
  responsibility plan; it does not replace pleadings, evidence, or a hearing.

2. Court and Case Information

3. Children and Jurisdiction Record

• Affidavit Concerning Children filed and current: ☐ Yes ☐ No ☐ Update needed

• Other custody, protection, child-welfare, or tribal order: ☐ None known
  ☐ Yes: [COURT, CASE, DATE, AND CONTROLLING TERMS]

• Confidential-address or safety procedure needed: ☐ No ☐ Yes

• Interstate jurisdiction facts requiring review: [________________________]

4. Decision-Making Responsibility

Joint custody under § 46b-56a does not by itself require equal physical time.
The court may approve only terms that serve the child's best interests.

Emergency care, notice, records, and follow-up procedure:
[____________________________________________________________]

5. Physical Custody and Parenting Time

Regular Schedule

Holidays, School Breaks, and Vacation

• Summer schedule: [_____________________________________________________]
• Vacation allocation and agreed notice: [_______________________________]
• School closures and weather disruptions: [____________________________]
• Temporary schedule-change process: [__________________________________]

6. Transportation, Travel, and Safety

• Parent responsible for ordinary transportation: [______________________]
• Holiday or summer transportation: [___________________________________]
• Exchange location and late-arrival contact: [__________________________]
• Travel itinerary and contact-information exchange: [__________________]

• Passport possession and international-travel terms, if ordered:
  [____________________________________________________________]

• Domestic violence or child-safety concern: ☐ No ☐ Yes. If yes, request
  protected, supervised, staggered, or third-party exchanges and any other
  necessary court-ordered conditions: [__________________________________]

7. Information Sharing and Parent-Child Contact

• School and activity calendar exchange: [_______________________________]
• Medical, dental, and mental-health notice: [___________________________]
• Emergency notice method and timing: [_________________________________]
• Telephone/video contact during the other parent's time: [_____________]
• Contact-address and telephone updates: [_______________________________]

Under § 46b-56(g), a parent not granted custody may not be denied access to
the child's academic and health records unless the court orders otherwise for
good cause. Identify any requested exception or protective order:
[____________________________________________________________]

8. Changing Needs and Future Disputes

The plan must address the child's changing needs and minimize exposure to
harmful parental conflict.

• Developmental, educational, medical, or disability-related review dates:
  [____________________________________________________________]

• Direct consultation method: [_________________________________________]

• Neutral professional or service the parents may consult voluntarily:
  [____________________________________________________________]

• Safety exception to joint consultation: [_____________________________]

• If no agreement is reached, either parent may use the applicable court
  procedure. No parent or private neutral receives unilateral authority to
  suspend, terminate, or rewrite court-ordered custody or parenting time.

9. Relocation

Connecticut § 46b-56d does not create a universal mileage trigger or a
statutory 60-day notice period. It applies after entry of a custody judgment
when a parent's relocation with the child would significantly affect an
existing parenting plan.

• Proposed agreed advance notice for address changes or relocation:
  [NUMBER] days, subject to emergency and confidentiality exceptions.

• Post-judgment move expected to significantly affect the plan: ☐ No ☐ Yes

• If yes, proposed location, purpose, child impact, contact schedule, travel,
  school, cost, and implementation terms: [______________________________]

• If contested, the relocating parent must address the burden and factors in
  § 46b-56d. Do not implement a custody-changing move based only on this
  private worksheet.

10. Failure to Honor the Plan

• Record the date, missed or disputed term, communications, child impact, and
  requested correction: [________________________________________________]

• Use safe, child-focused efforts to resolve temporary misunderstandings.

• Use the current court process for enforcement, contempt, emergency relief,
  or modification when needed.

• This worksheet creates no private event of default, cure period,
  indemnification duty, liability cap, automatic attorney-fee award,
  arbitration power, or self-executing change in custody.

11. Financial Issues Kept in the Court Process

JD-FM-284 contains child-support, health-care, child-care, withholding, and tax
sections. Complete those sections only with current financial affidavits, the
current Child Support and Arrearage Guidelines worksheet, and legal review.

• Existing support order and case: [_____________________________________]
• Financial sections completed in JD-FM-284: ☐ No ☐ Yes
• Separate support or health-care attachment: ☐ No ☐ Yes: [______________]

12. Court Review and Signatures

The parents ask the Superior Court to review the proposal and incorporate only
those terms the court approves. A final written agreement is subject to the
court's inquiry under § 46b-66 and does not become the controlling custody
order merely because the parents sign it.

Sources and Current Forms

• Current Connecticut General Statutes, Chapter 815j
• JD-FM-284, Custody Agreement and Parenting Plan
• Judicial Branch custody/visitation filing instructions
• Judicial Branch family form index

The current form index continued to list JD-FM-284, Rev. 9-21, on August 21,

2026. Recheck the index and judicial-district procedure on the filing date.