Each Canadian Co-Parenting Centre uses a variety of forms for a variety of things.  Some of them are provided here so that clients can review and complete the relevant ones prior to their first session.

Note to other professionals.

Please feel free to utilize all or part of these documents.  We only ask that you let us know that you are doing so.  This then creates an opportunity for collaboration and mutual benefit.



Intake Form

New Client Intake Form (basic information form)

If you review and complete, or partially complete, this form prior to your initial session it will save on valuable session time.  Plus, some of the details requested may have to be obtained from documents that you won't be bringing to your first session.  (Scroll down for link to download.)


Other Forms

Written agreements and guidelines help ensure that all parties clearly understand what the process will entail and what each person's roles and responsibilities are.

Note that customized agreements are created to match the needs of each family, but they are based on some standard templates.  To view these templates, use the menu on the left, or click on the link below.

Parenting Coordination Definition and Description & Statement of Intention

Parenting Coordination Definition and Description & Statement of Intention

Mediation Agreement

Mediation Guidelines

Fee Information

Fee and Deposit Agreement

Child Treatment Declaration

Authorization to Contact Other Significant Caregiver


New Client Intake Form

The following is a New Client Intake Form or a basic information form.  It is to be filled out by new clients so that we are provided with the necessary administrative and background information.

Preferably, clients will fill out this form prior to their first appointment, and at the beginning of that first meeting, the person they/you meet with will review it with them/you.  Besides making the first session more productive, filling it out in advance is generally easier, and some of the  particulars may have to be looked up on documents stored at home.

To download the form in Microsoft Word format, click on this link:  Intake Form.

Important Note:  Please note that the standard questions, at the top of page 3, are just that, standard questions that counselling agencies and private practitioners typically include.  We have included this comment to reassure those that are hyper vigilant because of a highly conflicted divorce process and are worried that something might be used against them.  As professionals working systemically, it is useful to have a broad, comprehensive understanding of what factors are influencing a family's environment and dynamics.

Canadian Co-Parenting Centres customize each parenting coordination agreement to suit each family's circumstances and needs.

Optimistically, we started off with a fairly simple, two page agreement that minimized the typical legal jargon.  Unfortunately, some people were able to thwart the parenting coordination process then continue with behaviours that were inappropriate and harmful to the children and the family.  Listed below are links to our original 2 page agreement, a 3 page agreement that we used for many years, and a very long and detailed agreement that was implemented in 2016.

The customization of each parenting coordination agreement primarily involves aspects of the role of the parenting coordinator and sometimes there are some alterations to the scope of the decision making authority.


Original Parenting Coordination Agreement

Pre 2016, 3 page, Parenting Coordination Agreement

Current, very detailed, Parenting Coordination Agreement

For many people, the current Parenting Coordination Agreement will seem daunting, overwhelming, and more than they need.  Since it's difficult to determine which people will turn out to be particularly challenging, we put the new detailed Parenting Coordination Agreement in place, even though the details are far more than what many families end up need, because both parents do their best to follow the advice given and to cooperate with the parenting coordination process.  Another benefit of the detailed Parenting Coordination Agreement is that it prevents the agency from being taken advantage of.  Preventing our valuable resources from being consumed by difficult people enables the agency to provide services to the majority of people at the lowest possible rate.


Co-parenting Coordination Guidelines

Co-parenting Coordination Guidelines have not been drafted yet.  Please refer to the Mediation Guidelines, and parents are asked to create an Agreed Commitments of Parents using the website www.UpToParents.org.  There is no charge for this service.

Also, the Co-Parenting Agreement from the website of Law Offices of Aaron Dishon, specifies some good standardized guidelines.


Mediation Agreement

Canadian Co-Parenting Centres customize each Meditation Agreement to suit each family's circumstances and needs.  The following is our standard template.


Mediation Guidelines

Here you can find our Mediation Guidelines.


Child Treatment Declaration

Our Child Treatment Declaration form can be found here. When providing counselling services to children it is usually therapeutically beneficial to have both parents, or all significant caregivers involved.  It is also ethically inappropriate to exclude a parent, or provide services without that parent's knowledge.

The Canadian Co-Parenting Centres use the following form to ensure that both parents, and any other significant caregivers*, are aware of the services being considered and that all are in favour of proceeding.

*In some situations, such as longer term common-law relationships, the child or children may have significant relationships with adults who are not a biological or adoptive parent.  If someone has been a significant caregiver, and in practical terms been like a parent, then we believe it is appropriate to treat them as such.

If one or more significant caregivers or parents is not available to sign this declaration, or if one of them is not participating in the child or children's treatment, an Authorization To Contact Other Significant Caregiver form will have to be filled out and signed.