Supervised Visitation Payment Form

  • Supervised Parenting Time (Visitation): A Case Aide oversees parent and child(ren) contacts for the duration of a scheduled parenting time visit. Case Aides do not intervene or direct the visit except in an instance when a child’s safety is compromised, or violations of Court orders or program policies occur.
  • Supervised Exchanges: A neutral third party (Case Aide) oversees the exchange of a child(ren) from one parent to the other parent at the start and end of parenting time. Supervised exchanges are offered in a group setting or individually.
    • An exchange is defined as one parent dropping off the child(ren) and the other parent picking up the child(ren)
  • Intake Assessment: A member of our staff will meet with custodial and non-custodial parent to conduct an interview to be able to assess the needs of the case as well as get to know the children and any special needs of the children. The intake also serves as the orientation for the program, services, and site visits.

No Shows/Cancellations: A charge equaling the full amount of the service that was to be provided will be charged to the cancelling party if a 24 hour advance notice of cancellation is not given.

Please fill out the form below to complete your payment

  • A copy of your receipt will be emailed to you.
  • Please note that one exchange includes one pick-up and one drop-off.
  • Copies are $1 per page.
  • $0.00