Request for Elder or Dependent Adult Restraining Order Allowing Contact

Judicial Council of California · Civil

Verified current as of August 1, 2026

This form allows someone to ask a court to issue a restraining order that permits limited contact between an elder or dependent adult and a person who has been ordered to stay away from them. Family members, conservators, or caregivers use this form when they need to modify an existing restraining order to allow specific, supervised, or restricted communication or visits.