1. Effective immediately, you are hereby authorized to have limited contact with your wife, *FULL NAME*. The limitations with respect to your contact with your wife are as follows:
YOU MAY:
- Resume communication with *FULL NAME* which includes, but is not limited to, communication in person, or through a third party, telephone, or in writing by letter, fax, or e-mail. All communications must occur within normal waking hours, generally 0700-2100.
- Attend joint appointments/meetings with health care professionals.
YOU MAY NOT:
- Resume living in the same domicile or sleep overnight with *FULL NAME* per recommendation of Family Advocacy.
2. I order you to avoid any confrontation with your spouse while this investigation is pending. Walk away from any provocation or confrontation that may develop during a visit and refrain from any verbal or physical abuse. This is for the protection of all parties involved.
3. The limitations of your contact with your spouse will remain in effect pending the evaluation of your case by your Family Advocacy counselor. This order will remain in effect until *DATE* unless otherwise extended or rescinded.
Soldier's signature ____________________________________________
You are being counseled in accordance with AR 635-200, paragraph 1-16, for your conduct as set forth in Part II above. Any further misconduct, inappropriate actions, or deficiencies in your performance may result in punitive action under the UCMJ and/or initiation of separation UP AR 635-200. Separation action may result in your service being characterized as Honorable, General, or Under Other Than Honorable Conditions (UOTH). An Honorable Discharge entitles you to receive all discharge benefits. A General Discharge may result in substantial prejudice in civilian life and loss of certain benefits, such as civil service retirement credit and educational assistance. An UOTH Discharge could result in substantial prejudice in civilian life, and may result in the loss of most or all benefits as a veteran under both Federal and State laws. Some of the benefits you would not be eligible for with an UOTH discharge are payment for accrued leave, health benefits, civil service preference, reemployment rights, unemployment compensation and naturalization benefits. An involuntary separation might result in recumbent of unearned enlistment bonuses, a loss of G.I. Bill or VEAP educational benefits, and no separation pay. It is very difficult to upgrade a less than honorable discharge.
