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 MONITORED EXCHANGE OF CHILDREN FOR
VISITATION THROUGH THE
SAFE FAMILY  PROGRAMS OF THE VICTIM ASSISTANCE CENTRE, INC.
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:
CHILD:_________________________
DOB:_________SS#______________

CHILD:_________________________
DOB:_________SS#______________

CHILD:_________________________
DOB:_________SS#______________

PETITIONER:__________________________

TDL:________DOB:______SS#____________

PESPONDENT:_________________________

TDL:________DOB:______SS#____________
IT IS ORDERED AND DECREED that all periods of the exchange of the minor
child/ren:_______________________________for visitation
with___________________________
shall be supervised at all times through the SAFE Supervised Exchange Program, a
project 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 Exchange Program, and
that both the Petitioner________________and Respondent________________
shall comply with all rules and regulations as promulgated by the SAFE Supervised
Exchange Program, or it's employee's, agents, associates, and/or volunteers to
perform any action in contravention of the SAFE Supervised Exchange Program's
rules and regulations. Further, the SAFE Supervised Exchange Program is in no way
a party to this order, and this order shall not be construed so as to prevent the
SAFE Supervised Exchange Programs from terminating any period(s) of Supervised
Exchanges which is/are determined by the SAFE Program to be inappropriate.

Signed on this ______day of _______________20__.


                                                           _____________________________________
                                                                             Presiding Judge