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JV-195Mandatory

Waiver of Reunification Services

California · Judicial Council of California · Effective July 1, 1998

This form is a waiver that a parent or guardian signs to give up their right to receive services that could help them live with their child again. It explains that signing this form could lead to the court ending parental rights and placing the child for adoption.

The court describes it as: A parent must use this if they are giving up their right to get services to help their child live with them again.

Open the official PDFfrom Judicial Council of California

Where this fits in a case

Motions

Stage: Motions

This form is used in a juvenile dependency case when a parent or guardian is giving up their right to reunification services.

Either party may file.

Official instructions

How-to guides published by the court for this form.

Common questions

Who needs to fill out this form?
The parent or guardian must use this form if they are giving up their right to get services to help their child live with them again.
What happens if I sign this form?
The form states that if the court is satisfied that the parent understands their rights and the consequences of giving them up, the court may end parental rights and have the child placed for adoption.
Does an attorney need to sign this?
The form includes sections for both an attorney's declaration and an interpreter's declaration.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect July 1, 1998.

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