CASE NO:_________________
IN THE MATTER OF THE MARRIAGE

_______________________________
                    VS

_______________________________

AND THE INTEREST OF

_______________________________

_______________________________
IN THE DISTRICT COURT OF




HARRIS COUNTY, TEXAS



________JUDICIAL DISTRICT
ORDER GRANTING SUPERVISED VISITATION THROUGH THE SAFE
SUPERVISED VISITATION PROGRAMS OF THE VICTIM ASSISTANCE
CENTRE, INC.


CHILD:_________________________
DOB:_________SS#_________

CHILD:_________________________
DOB:_________SS#_________

CHILD:_________________________
DOB:_________SS#_________

PETITIONER:__________________________

TDL:________DOB:______SS#___________

PESPONDENT:_________________________

TDL:________DOB:______SS#___________
On this the _____day of __________20_____, came to be heard
Petitioner's/Movant's/Respondent's Motion for
___________________.
This case involves the following child/ren and parties:
IT IS ORDERED AND DECREED that all periods of possession of or
access to the minor child/ren:_______________________________
shall be supervised at all times through the SAFE Supervised
Visitation Programs, projects of the Victim Assistance Centre,
Inc., 1310 Prairie Street Suite 1030, Houston, Texas 77002, phone
713-755-5625.
IT IS FURTHER ORDERED AND DECREED that both the
Petitioner____________________and
Respondent____________________shall contact the SAFE
Supervised Visitation Programs, phone number 713-755-5625
on or before the ______of__________, 20__ for the purpose of
securing an intake interview for registering for the above
ordered supervised visitation program, and that both the
Petitioner________________and Respondent________________
shall comply with all rules and regulations as promulgated by the
SAFE Supervised Visitation Programs, or it's employee's, agents,
associates, and/or volunteers to perform any action in
contravention of the SAFE Supervised Program's rules and
regulations. Further, the SAFE Supervised Program is in no way a
party to the order, and this order shall not be construed so as to
prevent the SAFE Supervised Programs from terminating any
period(s) of Supervised visitation which is/are determined by the
SAFE Program to be inappropriate.

Signed on this ______day of _______________20__.


_____________________________________
Presiding Judge