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Adoptive Parent Intake Form

Home » Adoption » Adoption Forms » Adoptive Parent Intake Form

Adoptive Parent Intake Form

Growing families for more than 35 years

Step 1 of 5

Husband’s Legal Name

(Please list full name — first, middle & last — as it appears on legal documents & vital record forms)

First Name

Middle Name

Last Name

Preferred Name

Suffix

Wife’s Legal Name

(Please list full name — first, middle & last — as it appears on legal documents & vital record forms)

First Name

Middle Name

Last Name

Preferred Name

Wife’s Maiden Name

(Please list full maiden name — first, middle & last — as it appears on legal documents & vital record forms)

First Name

Middle Name

Last Name

Marriage Date *

City and County *

Marriage State *

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone *

Fax

Who should we call first? *

HusbandWife

Cell (His) *

Cell (Hers) *

Business (His) *

Business (Hers) *

Email (His) *

Email (Hers) *

Family Information

Do you have any children? *

YesNo

Add your children's information below. Use the + and - icons to the right to add or remove children from this list.

Children

Name *

Date of Birth *

Race *

Relationship *

Adoptive Father

Date of Birth *

Place of Birth *

Height *

Weight *

Hair Color *

Eye Color *

Number of previous marriages *

Religion *

Race *

Last grade or degree completed *

Occupation *

Occupational Industry *

Annual Salary* *

Hobbies & Interests *

Adoptive Mother

Date of Birth *

Place of Birth *

Height *

Weight *

Hair Color *

Eye Color *

Number of previous marriages *

Religion *

Race *

Last grade or degree completed *

Occupation *

Occupational Industry *

Annual Salary* *

Hobbies & Interests *

*Please include all income, even if it is from part-time work or a hobby.

Adoption Information & Preferences

Do you have a current Home Study (completed within the last 9 months)? *

Completed by:

Are you willing to travel to another state? *

YesNo

Matching Preference *

Self-matchingTraditional MatchingBoth

Minimum Age Preference *

Maximum Age Preference *

Gender *

Either male or femalePrefer girl, consider boyPrefer boy, consider girl

Race *

AllAmerican IndianAfrican AmericanAsianBiracialCaucasianHispanic

Number of Children *

One ChildTwinsSibling Group (2 children)Sibling Group (3 children)

Additional Information

Why do you wish to adopt? *

Are you willing to consider a child with special needs? If so, to what extent? *

Are you open to accepting a drug-exposed child? Are you open to a birth mom who drinks alcohol? To what extent? *

Are you willing to consider a situation where the birth mother has been diagnosed with a mental illness (i.e. depression, bipolar, schizophrenia)? Please specify what conditions you would consider if given more information: *

Adoption is an emotional rollercoaster. Please discuss a difficulty you have faced in your life and how you overcame it. What was your support system during this difficult time? *

Have you read any books on adoption or attended any seminars? If so, please explain: *

Do you have an active social media presence? Are you an influencer or blogger? *

How soon do you hope to complete an adoption? *

After the child is placed in your home, will both parents work outside the home? If so, what are your plans for childcare? *

Most of our adoption placements are semi-open placements; however, some birth mothers prefer more openness. What is your comfort level responding to the following: phone calls, letters, pictures, updates, and visits?” *

Please list any additional languages you speak: *

Please share with us the 3 most positive things or events that have happened in your life and the 3 most difficult experiences that you’ve encountered. How did you react/cope with those situations? *

Please remember that you will be at the hospital by yourselves but that we will be available by phone after hours to advise you and provide you guidance. With this in mind, please answer the following:

Your adoption journey can be a roller coaster ride: if your birth mother stops communicating with you for a week or so, how would this affect you? *

If you are at the hospital and the birth mother is struggling to make a decision about placing her baby with you, how would you cope with this development? *

How did you hear about our office? *

Any additional notes?

We hereby give our permission for Godwin & Horst, Attorneys at Law to use any photos that we send to their office for use on their website, pamphlets, booklets, or published materials. *

YesNo

Adoption Forms

Adoptive Parent Intake Form
Adoptive Parent Intake Form: Matched with Birth Mother
Adoptive Parent Intake Form: DSS Foster-Adopt
Adoptive Parent Intake Form: Re-Adopt or Foreign Adoption (Finalized in USA)
Custody Intake Form
Step-Parent Intake Form
Family Member Adoption Intake Form
Birth Mother Intake Form
Re-Adopt/Domestication Intake Form

We thoroughly enjoyed working with Ray, Lori, Marion, and the team! They are great communicators, timely in getting the ball rolling, and really held our hand through a process that can be very stressful and emotional. Paperwork was handled without difficulty, and we're blessed to have worked with and been represented by such a great team!

The B. Family
We couldn't say enough good things about Families by Adoption, PC, especially Lori Horst. Lori handled every detail with integrity, transparency, and a deep respect for everyone involved. We are incredibly grateful for Lori's guidance and support in helping us bring our daughter home. We highly recommend Lori Horst and Families by Adoption, PC to anyone considering adoption. Having her by your side throughout the journey is truly a blessing.

The G. Family
We are incredibly grateful for the outstanding support and guidance we received throughout our adoption process. Their dedication and genuine care for our family truly showed in every interaction. We highly recommend their services to anyone looking for a trustworthy and experienced adoption attorney.

The L Family
Families by Adoption took fantastic care of us from the very first phone call all the way through our finalization and beyond. They have a wonderful staff working around the clock to make sure everything is handled appropriately. If adoption is in your heart, then I suggest working together with Families by Adoption.

The M Family
Lori is amazing! She has the unique perspective of not only being a great lawyer but an adoptive mom herself so she gets it! Adoption is a journey with many ups and downs, and she was wonderful in helping us navigate the difficult parts. We are so thankful she was our attorney as we welcomed our daughter to our family.

The W. Family

Disclaimer pursuant to Rule 7.1 South Carolina Rules of Professional Conduct: This is a testimonial by a former client of Godwin & Horst, Attorneys at Law. The result achieved on behalf of one client does not necessarily indicate similar results can be obtained for other clients.

We Put Our Experience to Work for You

If you are ready to adopt or if you would like to speak with an attorney regarding adoption, our firm is prepared to assist.

Begin the process by completing the Adoptive Parent Intake Form, which can be found under the Forms tab. You can also contact us to learn more. All matters are handled with the utmost sensitivity and confidentiality. We look forward to helping you begin your journey.

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