SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF -------------------------------------------------------------------X Plaintiff, Index No.: -against- ORDER FOR SUPERVISED VISITATION Defendant. ------------------------------------------------------------------X J.: IT IS HEREBY ORDERED , that visitation between , the plaintiff / defendant herein, and the child(ren), , shall only take place at the supervised visitation program of The New York Society for thePrevention of Cruelty to Children (The NYSPCC) until further order of this Court; and it is further ORDERED , that the visitation shall begin no later than ; and it is further ORDERED , that the frequency of visitation shall within the discretion of The NYSPCC; be and itis further ORDERED , that the parties shall abide by the termand s conditions of the supervised visitation program as established by The NYSPCC; and it is further ORDERED , that this matter is adjourned to . Dated: E N T E R : Justice Supreme Court Order For Supervised Visitation September 2004 American LegalNet, Inc. www.USCourtForms.com