Parental Controls Log Form
Use this form to record all parental control activity and settings changes. Title: Parental Controls Log Form.
Date and Time of Activity
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Name of Person Making Change
*
First Name
Last Name
Type of Parental Control Action
*
New Restriction Set
Restriction Modified
Restriction Removed
Temporary Allowance
Schedule Changed
Other
Device(s) Involved
*
Phone
Tablet
Computer
Smart TV
Game Console
Other
Type of Restriction
*
App Blocked
Website Blocked
Time Limit Set
Screen Time Schedule
Purchase Restriction
Other
Specific App(s) or Website(s) Involved
Schedule or Time Period Applied
Reason for Change
Follow-up Action Needed
No Follow-up Needed
Review Settings
Notify Parent/Guardian
Other
Additional Notes
Submit Log Entry
Should be Empty: