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Custody Intake Form

Home » Adoption » Adoption Forms » Custody Intake Form

Custody Intake Form

Growing families for more than 35 years

Step 1 of 6

Custody Intake Form

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

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

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

Husband's Date of Birth

Husband's Place of Birth

Wife's Date of Birth

Wife's Place of Birth

Marriage Date

Marriage City

Marriage State

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

City

State

Zip

County

Home Phone

Fax

Who should we call first?

HusbandWife

Cell (his)

Cell (hers)

Business (his)

Business (hers)

Email (his)

Email (hers)

Children

Children

Name

Date of Birth

Race

Relationship

Additional Client Information

Please list any additional languages that you speak

Have either of you ever been convicted of a crime?

YesNo

If so, for what were you convicted?

Has there been any record of child abuse in your history?

YesNo

If so, in what state were you accused?

Information of Child(ren) to be Adopted

Child Details

Birth Name

Date of Birth

Gender

Race

Place of Birth

Hospital Address

Hospital City

Hospital State

Hospital Zip

Date of Placement

Placement City

Placement State

Guardianship Papers?

YesNo

Custody Information

What is the relationship of the Birth Mother and/or Birth Father to you?

What kind of relationship do the child(ren) have with the birth mother/birth father currently?

How did you gain custody of the child(ren)

Have you retained any other legal assistance in this matter?

Birth Mother Information

First Name

Middle Name

Last Name

First Name

Middle Name

Last Name

Were you married to the child's biological father?

YesNo

Birth Mother Phone Number

Birth Mother Date of Birth

Birth Mother Social Security Number

Birth Mother Race

Birth Mother Last Known Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Amount of visitation in the last 3 years

Amount of child support paid in the last 3 years

Is birth mother incarcerated?

YesNo

If so, how long?

What facility is she in?

Facility Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Reason for incarceration

Is birth mother in favor of custody?

YesNo

Birth Father Information

First Name

Middle Name

Last Name

Married?

YesNo

Spouse's Name

Were you married to the child's biological mother?

YesNo

Birth Father Phone Number

Birth Father Date of Birth

Birth Father Social Security Number

Birth Father Race

Birth Father Last Known Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Amount of visitation in the last 3 years

Amount of child support paid in the last 3 years

Is birth father incarcerated?

YesNo

If so, how long?

What facility is he in?

Facility Address (birth father)

Address Line 1

Address Line 2

City

State

Zip Code

Country

Reason for incarceration

Is birth father in favor of custody?

YesNo

How did you hear about our office?

Any additional notes?

We hereby give our permission for Raymond W. Godwin, Esq. to use any photos that we send him or his office for use on his website, pamphlets, booklets, or published material.

Photo permission

We agreeWe disagree

Please save your completed intake form and email it as an attachment to our office at assistant@scadopt.net.

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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Last Name

Email

Phone/Mobile

Message

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Greenville, SC 29615

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