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Dept. Human Services

Independent adoption forms

The following forms are needed when filing a private adoption petition. Each adoption category requires a particular form(s), so you need to print only those forms that apply to your adoption. For questions, please call 503-945-5670.


Face Sheet

PDF, Word, Wordperfect 
Recommended for all adoptions; to help streamline the adoption process.

Adoption Disclosure Statement

PDF, Word, Wordperfect 
List of expenses related to adoption. Required for all adoptions.

Voluntary Adoption Registry Notification Sample Form

PDF, Word, Wordperfect 
For all adoptions. For more information view the Voluntary Adoption Registry.

Genetic and Medical History of Child and Family (CF 246)

PDF, Word,

Non-State Department of Human Services (CF 246A, Genetic/Medical History)

PDF, Word, Wordperfect

Required for all adoptions (except step-parent adoption).  To be used in conjuction with CF 246.  Please fill out as completely as possible.

Adoption report

(PDF 12 KB): Information from the original certificate. Required for all adoptions.

Request for Oregon Criminal History Information

PDF, Word

Mainly for step-parent and relative adoptions; all adults in the home must submit to a criminal background check. If a step-parent adoption, the biological or legal parent is exempted from this requirement.

 

Waiver of Home Study & Placement Report Form and Instructions

PDF, Word
Mainly for step-parent and relative adoptions.

 

Request for Waiver of Independent Adoption Fees Statement of Household Earnings

PDF, Word, Wordperfect 
For people with limited financial resources and need a home study/post-placement report for their adoption. For more information view the description.

Affidavit Verifying Provision of Notice of Right to Payment for Adoption-Related Counseling Pursuant to ORS 109.346

PDF, Word, Wordperfect 
For agency and non-related (independent) adoptions only.

Notice of Right to Payment for Adoption-Related Counseling

PDF, Word, Wordperfect

 

Private Agency and Independent Adoption Disruption/Dissolution Report 

Only for the use of private adoption agencies to report an adoption disruption or dissolution.

PDF ,  WORD  


 

 
Page updated: September 21, 2007

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