Intake Form: Adoption
By Lisa Burden, J.D. | Legally reviewed by Rhonda Earhart, Esq. | Last reviewed July 18, 2023
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There's no denying that the adoption process involves a lot of paperwork. When you hire a family law attorney, they'll guide you through the documentation necessary to expand your family. You can help by filling out the following questionnaire before your initial meeting with your family law attorney.
Client Intake Form: An Overview
The intake form for adoption compiles data on the prospective adoptive parents, the birth parents, and the adoptee.
Prospective adoptive parents must supply personal information. This includes their full names, legal names, dates of birth (DOB), and present addresses. If applicable, provide your maiden name or former name. Disclose details about previous marriages and divorces.
If the biological parents are known and involved, the parent intake form should include their information. Provide their full names and addresses. It would help to share information about:
- The natural parents' readiness to consent to the adoption
- Their understanding of the process
- Their relationship with the child
Provide details about the future adopted child on the client intake form. Disclose information on the child's birth, such as date of birth (DOB) and place of birth. If available, supply a certified copy of the child's birth certificate.
Inform your attorney about any existing legal matters. Provide information about custody disputes, outstanding child support obligations, etc.
Tell your attorney about previous adoption attempts.
Additionally, disclose health history, including alcoholism or drug abuse. Your attorney can protect your interests if these issues look like they're going to affect or delay the adoption process.
A good family law attorney with experience in the adoption process can ease your anxiety.
Note: We use "Adoptive parent 1" and "Adoptive parent 2" for inclusivity. If you prefer, you can substitute "Adoptive mother" or "Adoptive father."
| Adoptive parent 1 | Adoptive parent 2 |
|---|---|
| Name________________________________ | ______________________________ |
| Date of birth___________________________ | ______________________________ |
| Social Security number__________________ | ____________________ |
Address, including county |
|
| Length of time at that address _______ years | _______ years |
| Previous address(es) (for last 10 years) | |
| Home telephone number ____________________ | ____________________ |
| Work telephone number ____________________ | ____________________ |
| Fax number ____________________ | ____________________ |
| Email Address ____________________ | ____________________ |
| Former name(s) ____________________ | ____________________ |
| ____________________ | ____________________ |
| Employers ____________________ | ____________________ |
| Position ____________________ | ____________________ |
| Employer's address | |
| ______________________________ | ______________________________ |
| ______________________________ | ______________________________ |
| ______________________________ | ______________________________ |
| Length of time with employer _______ years | _______ years |
| Previous employer(s) (for last 10 years) | |
| ______________________________ | ______________________________ |
| ______________________________ | ______________________________ |
| ______________________________ | ______________________________ |
| ______________________________ | ______________________________ |
| Gross monthly income $_________________ | $_________________ |
| Other income | |
| Source/amount ________________________ | _________________________ |
| Source/amount ________________________ | _________________________ |
| Source/amount ________________________ | _________________________ |
| Date of marriage _________________________________ | |
| Place of marriage ________________________________ | |
| Previous marriage(s) Yes ____ No ____ | Yes ____ No ____ |
| Ended by: | Ended by: |
| Death ____ Divorce ____ Date ______ | Death ____ Divorce ____ Date _____ |
| Death ____ Divorce ____ Date _____ | Death ____ Divorce ____ Date _____ |
| Children of current marriage | |
| Name, Date of birth | Adopted? Living in the home? Race/Nationality |
| _______________________ _________ | Yes/No Yes/No __________ |
| _______________________ _________ | Yes/No Yes/No __________ |
| _______________________ _________ | Yes/No Yes/No __________ |
| _______________________ _________ | Yes/No Yes/No __________ |
| _______________________ _________ | Yes/No Yes/No __________ |
| Children from other marriages or relationships | |
| Name, Date of birth | Adopted? Living in the home? Race/Nationality |
| _______________________ _________ | Yes/No Yes/No __________ |
| _______________________ _________ | Yes/No Yes/No __________ |
| _______________________ _________ | Yes/No Yes/No __________ |
| _______________________ _________ | Yes/No Yes/No __________ |
I/we am/are interested in (check all that apply): Domestic adoption _____ Intercountry adoption _____ Open adoption _____ Closed adoption _____ Infant adoption _____ (under 12 months) Older child _____ (state desired age range _____-_____) Sibling groups _____ Do you have a gender preference? Yes, I/we prefer a ___________. No _____ State desired race or ethnicity of child(ren), if any. _____________________ If you are considering intercountry adoption, are there particular countries you are interested in? _______________________ I/we have the following amount available to fund the adoption (may affect options): Up to $1,000 _____ $1,000 to $5,000 _____ $5,000 to $10,000 _____ $10,000 to $20,000 _____ $20,000 to $30,000 _____ Over $30,000 _____ Do you have a completed home study? Yes _____ No _____ Has an adoption ever been denied to you? Yes _____ No _____ Have you ever been arrested? Adoptive parent 1: _______ Adoptive parent 2: _______ If yes, explain: Are you in good health? Adoptive parent 1: ________ Adoptive parent 2: _______ Explain all current and chronic illnesses, past and future surgeries, medications you are taking, and other relevant health information: Do you have a history of alcohol or drug abuse? Adoptive parent 1: ________ Adoptive parent 2: ________ List three references who have known you for at least five years. Include a family member, a co-worker, and a social friend or neighbor. |
|
| Name, Address | Relationship, How long known? |
| ______________ ____________________ | _______________ ____________ |
| ______________ ____________________ | _______________ ____________ |
| ______________ ____________________ | _______________ ____________ |
Other important information Questions to ask my attorney |
Next Steps
Contact a qualified attorney specializing in adoptions.