Prisoner's Statement Regarding Appearance at Hearing Affecting Parental Rights
California · Judicial Council of California · Effective January 1, 2012
This form is for a person who is in jail or prison to tell the juvenile court how they want to appear at a hearing about their child. It asks the person to state if they want to attend in person, by video, or by phone, and also addresses their right to an attorney.
The court describes it as: If you are in prison or jail, use this to tell the juvenile court whether you want to attend the hearing about your child in person, or want to participate by video or telephone.
Where this fits in a case
HearingStage: Hearing
This form is used by a parent who is currently incarcerated when a hearing is scheduled that affects their parental rights regarding a child.
Either party may file.
Official instructions
How-to guides published by the court for this form.
Common questions
- Who should fill out this form?
- The form is for the prisoner to complete, and it also requires signatures from an interpreter and the person in charge of the institution.
- What does this form cover?
- It covers the prisoner's wishes regarding their physical presence, participation by video or phone, and their understanding of their rights to an attorney.
- Are there any fees mentioned?
- The text does not mention any filing fees for this form.
Revision history
No changes recorded since we started tracking this form on October 9, 2026. The current version took effect January 1, 2012.
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