Adult Adoption Intake Form

ADULT ADOPTION INTAKE FORM

Please take time to complete this intake form before we meet. Please be as specific as you can. We will call you promptly to schedule your consultation.

Your answers in this short questionnaire will give us the information we need to: 1) fully advise you during your consultation, and 2) use this information to prepare your legal pleadings.

The information you provide is confidential. If you do not retain us, the intake form will be destroyed. Be aware that completing this questionnaire alone does not create an attorney-client relationship. We reserve the right to decline representation after your initial consultation.

Please enable JavaScript in your browser to complete this form.

1A. FULL NAME (FIRST-MIDDLE-LAST) OF ADOPTING PARENT (OR STEPPARENT IF THIS IS AN ADULT STEPPARENT ADOPTION): *

INFORMATION ABOUT ADOPTING PARENT #1:

1B. Email *

1C. Phone Number *

1D. Home Address *

(STREET, CITY, STATE, ZIP):

1E. IF MARRIED, THE DATE OF MARRIAGE: *

1F. IS THE PERSON YOU ARE ADOPTING RELATED TO YOU, OR THE CHILD OF YOUR SPOUSE (YOUR STEPCHILD)? PLEASE EXPLAIN: *

2A. IS THE ADOPTING PARENT MARRIED TO THE PARENT OF THE ADOPTEE (AN ADULT STEPPARENT ADOPTION)? IF YES, PROVIDE THE FULL LEGAL NAME OF THE SPOUSE, HIS/HER DATE AND CITY/STATE OF BIRTH, PHONE AND E-MAIL: *

INFORMATION ABOUT ADOPTING PARENT #2 (OR EXISTING PARENT IF A STEPPARENT ADOPTION)

2B. IF THERE ARE TWO ADOPTING PARENTS, THE FULL NAME OF THE SPOUSE (THE OTHER ADOPTIVE PARENT). IF ONLY ONE ADOPTING PARENT, SKIP TO QUESTION 3A.

2C. PHONE:

2D. E-MAIL:

3A. HAVE EITHER OF THE ABOVE PARTIES ADOPTED AN ADULT WITHIN THE LAST YEAR? *

3B. IS EITHER OF THE ABOVE A PROVIDER/EMPLOYEE OF BOARD AND CARE, TREATMENT OR OTHER SERVICES TO PERSONS WITH DEVELOPMENTAL DISABILITIES? *

3C. PLEASE DESCRIBE THE NATURE OF THE RELATIONSHIP BETWEEN THE ADOPTING PARENT(S) AND THE ADOPTEE AND DETAILS ON WHY THE ADOPTION IS DESIRED. PLEASE LIMIT REPLY TO 4 SENTENCES. *

4A. FULL LEGAL NAME (FIRST-MIDDLE-LAST) OF THE ADOPTEE: *

INFORMATION ABOUT THE ADOPTEE (THE PERSON BEING ADOPTED)

4B. AFTER THE ADOPTION, WHAT DOES THE ADOPTEE WANT THEIR LEGAL NAME TO BE (FIRST-MIDDLE-LAST)? *

4C. ADOPTEE'S PHONE:

4D. ADOPTEE'S E-MAIL: *

4E. ADOPTEE'S HOME ADDRESS (STREET, CITY, STATE, ZIP): *

4F. ADOPTEE’S DATE OF BIRTH AND CITY/STATE OF BIRTH: *

4G. IS THE ADOPTEE MARRIED? IF YES, FULL LEGAL NAME OF SPOUSE (S/HE WILL NEED TO CONSENT): *

4H. DOES THE ADOPTEE HAVE ANY ADULT CHILDREN? *

4I. LEGAL NAME OF ADOPTEE’S MOTHER. *

(NOTE: ADOPTEE’S PARENTS ARE NOT REQUIRED TO BE GIVEN NOTICE BUT THE COURT REQUIRES THEY BE IDENTIFIED IN THE PETITION FOR ADOPTION.)

4J. LEGAL NAME OF ADOPTEE’S FATHER: *

4K. DOES THE ADOPTEE HAVE ANY DEVELOPMENTAL DISABILITIES? *

5A. NAME OF PERSON COMPLETING THIS QUESTIONNAIRE: *

How did you hear about the Law and Mediation Offices of Kelly Chang? *

Submit