Request Services

Request Form for Supervised Visitation and Exchange Services

Thank you for choosing Bridging Families for your Supervised Visitation and Exchange Services needs!

To request our supervised visitation and exchange services, please complete the form below. There is a $75 intake fee per party, totaling $150 for intake. For a breakdown of service costs across different counties, please refer to our Cost of Services page.

If you have any questions or need assistance, feel free to contact us at info@bridgingfamilies.org.

Parent Information

Other Parent Information

Location of Supervised Visit or Exchange

How many children will be present at the supervised visitation as requred by court order?

How many hours each week are you obligated to complete as per the court's order?

Upload Signed Service Contract and Terms of Service:

Service Contract and Terms of Service
Upload up to 10 supported files. Max 10 MB per file. (.pdf, .doc, .docx)

Attach a recent photo of yourself and/or a clear copy of your driver’s license or other photo identification here:

Attach ALL applicable court orders and/or restraining orders here:

Upload up to 10 supported files. Max 10 MB per file. (.pdf)

Attach a photo of your child(ren):

Upload up to 10 supported files. Max 10 MB per file. (.jpg, .jpeg, .png)

When are you available for an intake meeting?

Please schedule an intake meeting and share your availability. After receiving your response, we’ll confirm the virtual meeting date and time and provide additional details.