Consent Agreement and Dating Violence Civil Protection Order

This form is a Consent Agreement and Dating Violence Civil Protection Order that asks the court to legally restrict the Respondent from certain actions against the Petitioner and other protected people. It details specific rules the Respondent must follow after the order is issued.

Common questions

Who fills out this form?

The form is a consent agreement, meaning both parties are agreeing to the terms before the court signs the order. The court also completes it. Great care must be taken to fill out all required information.

What does this order do?

The court uses this form to legally order the Respondent to stop certain actions, such as abuse, stalking, or contacting the Petitioner. The order can last up to five years.

Are there fees involved?

The form states that no costs or fees shall be assessed against the Petitioner for filing or obtaining a copy of the order.

Revision history

No changes recorded since we started tracking this form on October 10, 2026.

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