Grandparent Visitation Petition

IMPORTANT: PREPARATION GUIDE — NOT THE OFFICIAL COURT FORM

Massachusetts requires the use of an official court form for grandparent visitation: CJ-D 105
(Petition for Grandparent(s) Visitation, Probate and Family Court) or JV-53 (Juvenile Court).
This template provides the substantive legal content to help you prepare — transfer your content to
the official form before filing. Forms: https://www.mass.gov/info-details/massachusetts-law-about-grandparents-visitation-rights

Commonwealth of Massachusetts

Probate and Family Court Department

[DIVISION] Division

PETITION FOR GRANDPARENT VISITATION

(M.G.L. c. 119, § 39D)

NOW COMES the Petitioner, [PETITIONER FULL LEGAL NAME], and respectfully petitions the Probate and Family Court, [DIVISION] Division, pursuant to M.G.L. c. 119, § 39D, for an order granting reasonable visitation with the minor child named above, and states as follows:

1. PARTIES

1.1 Petitioner (Grandparent)

1.2 Co-Petitioner (if applicable)

1.3 Respondent(s) (Parent(s) / Legal Custodian(s))

1.4 Minor Child

2. JURISDICTION AND VENUE

2.1 Subject-Matter Jurisdiction. The Probate and Family Court Department has jurisdiction to grant reasonable grandparent visitation under M.G.L. c. 119, § 39D, upon a written finding that such visitation is in the best interest of the minor child, subject to the constitutional standard described in Section 5 below.

2.2 UCCJEA. Massachusetts is the "home state" of the minor child under the Massachusetts Child Custody Jurisdiction Act / UCCJEA, M.G.L. c. 209B, because (check one):

☐ The child has lived in Massachusetts with a parent or person acting as a parent for at least six (6) consecutive months immediately before commencement of this proceeding;

☐ The child is less than six (6) months old and has lived in Massachusetts since birth;

☐ Other jurisdictional basis under M.G.L. c. 209B: [____________]

2.3 Venue. Where applicable, this Petition is filed in the county in which the divorce, separate-support, or paternity complaint was filed. If that judgment was entered outside the Commonwealth and the child now resides in Massachusetts, this Petition is filed in the county where the child resides. M.G.L. c. 119, § 39D. The child resides in [COUNTY], Massachusetts.

2.4 Other Proceedings. (check one): ☐ No other custody/visitation proceeding concerning the child is pending or has concluded. ☐ The following proceeding exists/existed — Court: [____________]; Docket No.: [____________]; Status: [____________].

3. STANDING (M.G.L. c. 119, § 39D)

3.1 Petitioner is a grandparent of the unmarried minor child. Petitioner has standing under § 39D because (check the applicable basis):

☐ The parents of the child are divorced;

☐ The parents are married but living apart;

☐ The parents are under a temporary order or judgment of separate support;

☐ One or both parents are deceased;

☐ The child was born out of wedlock and (i) paternity has been adjudicated by a court of competent jurisdiction or the father has signed an acknowledgment of paternity, and (ii) the parents do not reside together (NOTE: a maternal grandparent need not prove adjudication or acknowledgment of paternity to proceed).

3.2 Adoption bar. No visitation may be granted if the child has been adopted by a person other than a stepparent; any visitation granted before such adoption terminates automatically upon adoption. M.G.L. c. 119, § 39D. (check one): ☐ The child has not been adopted by a non-stepparent. ☐ Not applicable.

4. FACTUAL ALLEGATIONS (DETAILED — see Verification in Section 9)

4.1 History of the relationship. [DESCRIBE in detail — duration and frequency of contact; whether the child ever resided with Petitioner; caregiving provided; activities, holidays, and milestones shared; the depth of the bond/attachment]:

[____________]

4.2 Circumstances leading to this Petition. [DESCRIBE in detail — when and how contact ceased or was curtailed; the reason(s); efforts to resolve informally]:

[____________]

4.3 Significant-harm allegations (REQUIRED). Petitioner alleges and will prove by a preponderance of the evidence that the failure to grant visitation will cause the child significant harm by adversely affecting the child's health, safety, or welfare. The specific factual basis is (check all that apply and provide detail):

☐ Petitioner was a primary caregiver / central attachment figure, and the abrupt, total severance of that relationship is damaging to the child's emotional health and development: [____________]

☐ The child has exhibited identifiable adverse effects (e.g., distress, regression, behavioral or emotional symptoms) attributable to the loss of contact: [____________]

☐ A parent's conduct (e.g., abuse, neglect, instability, substance abuse) makes continued contact with Petitioner necessary to protect the child from significant harm: [____________]

☐ Other specific facts demonstrating significant harm: [____________]

4.4 Prior contact considered. The Court is asked to weigh the amount and quality of Petitioner's prior personal contact with the child, summarized above.

4.5 Child's preference (if of sufficient age and maturity). (check one): ☐ The child has expressed a desire to spend time with Petitioner: [____________] ☐ The child is too young to express a meaningful preference.

5. CONSTITUTIONAL AND STATUTORY STANDARD

5.1 Parental rights; special weight (Troxel). A fit parent has a fundamental constitutional right to make decisions concerning the care, custody, and control of the child. A fit parent's decision regarding grandparent visitation is entitled to "special weight" and presumptive validity. Troxel v. Granville, 530 U.S. 57 (2000).

5.2 Massachusetts significant-harm standard (Blixt). To rebut the parental presumption, Petitioner must allege and prove by a preponderance of the evidence that the failure to grant visitation will cause the child significant harm by adversely affecting the child's health, safety, or welfare. Blixt v. Blixt, 437 Mass. 649 (2002). The statute was upheld against a due process challenge precisely because it is narrowly tailored to the compelling state interest in protecting a child who has experienced a family disruption from harm.

5.3 Best interest finding. The Court may grant visitation only upon a written finding that visitation is in the best interest of the child, after the significant-harm showing in § 5.2 is satisfied. M.G.L. c. 119, § 39D.

6. BEST-INTEREST FACTORS

Petitioner alleges that the requested visitation is in the child's best interest, considering (check all that apply):

☐ The nature, strength, and duration of the bond between Petitioner and the child;

☐ The emotional benefit and stability the relationship provides;

☐ Petitioner's ability to provide a safe and nurturing environment during visitation;

☐ The child's schedule (school, activities, religious observance) and accommodation of it;

☐ Petitioner's willingness to support, and not undermine, the parent-child relationship;

☐ The absence of any history of abuse, neglect, domestic violence, or substance abuse by Petitioner;

☐ Other factor relevant to the child's welfare: [____________]

7. REQUESTED VISITATION SCHEDULE

7.1 Regular visitation. ☐ Weekly — [SPECIFY] ☐ Bi-weekly — [SPECIFY] ☐ Monthly — [SPECIFY] ☐ Other — [____________]

7.2 Holidays and special occasions.

7.3 Communication. ☐ Telephone — [frequency] ☐ Video calls — [frequency] ☐ Mail/cards

7.4 Transportation / exchange. ☐ Petitioner will provide transportation ☐ Exchange location: [____________]

8. PRAYER FOR RELIEF

WHEREFORE, Petitioner respectfully requests that this Honorable Court:

A. Find that Petitioner has alleged and proved that denial of visitation will cause the child significant harm under Blixt v. Blixt;

B. Make a written finding that the requested grandparent visitation is in the best interest of the minor child under M.G.L. c. 119, § 39D;

C. Enter an order granting Petitioner reasonable visitation on the schedule set forth in Section 7, or as the Court deems appropriate;

D. Grant Petitioner reasonable telephone, video, and written communication with the child;

E. Award costs of this action; and

F. Grant such other and further relief as the Court deems just and proper.

9. VERIFICATION / DETAILED VERIFIED AFFIDAVIT

I, [PETITIONER NAME], on oath depose and state that I am the Petitioner; that I have read the foregoing Petition, including the detailed factual allegations in Section 4; and that the facts stated therein are true of my own personal knowledge, except as to matters stated on information and belief, and as to those matters I believe them to be true.

Signed under the pains and penalties of perjury this [____] day of [MONTH], [YEAR].

Signature: _________________________________

Print Name: [____________]

10. SIGNATURE

Respectfully submitted,

Date: [__/__/____]

_________________________________
[PETITIONER NAME], Petitioner (Pro Se)

— or —

_________________________________
[ATTORNEY NAME] (BBO No. [____________])
[FIRM NAME]
[ADDRESS]
[TELEPHONE] | [EMAIL]
Attorney for Petitioner

11. NOTICE TO RESPONDENT

TO THE RESPONDENT(S): You have been served with a Petition for Grandparent Visitation under M.G.L. c. 119, § 39D, together with a summons/citation issued by the Court. You must file a written appearance and any response by the date stated in the citation. If you fail to respond, the Court may proceed in your absence. You have the right to appear at any hearing and to be represented by an attorney.

12. CERTIFICATE OF SERVICE

I certify that on [__/__/____], a copy of the foregoing Petition (and supporting affidavit, if separate) was served upon the following by the method indicated:

Respondent 1 — Name: [____________]; Address: [____________]; Method: ☐ Hand delivery ☐ Certified mail ☐ Other: [____________]

Respondent 2 — Name: [____________]; Address: [____________]; Method: ☐ Hand delivery ☐ Certified mail ☐ Other: [____________]

Signature: _________________________________

SOURCES & REFERENCES

• M.G.L. c. 119, § 39D — Visitation rights to certain grandparents of unmarried minor children; standing categories; best-interest written finding; adoption bar; venue. https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter119/Section39D
• Blixt v. Blixt, 437 Mass. 649 (2002) — Significant-harm standard; presumptive validity of a fit parent's decision; petition must be detailed and verified (or accompanied by a detailed verified affidavit).
• Martinez v. Martinez-Cintron, 93 Mass. App. Ct. 202 (2018) — Inadequate petition that fails to allege significant harm must be dismissed.
• Frazier v. Frazier, 96 Mass. App. Ct. 775 (2019) — Motion to dismiss required where petition does not plausibly suggest significant harm.
• Troxel v. Granville, 530 U.S. 57 (2000) — Fit parents' visitation decisions entitled to "special weight."
• M.G.L. c. 209B — Massachusetts UCCJEA (jurisdiction; home state).
• Massachusetts Courts: https://www.mass.gov/info-details/massachusetts-law-about-grandparents-visitation-rights