Adoption Records Free Waiver

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          The following form template is formatted to fit an adoptee, but birth parents can copy and modify it to fit their needs as well. All words in blue italics without parenthesis are to be changed to your own personal information. Information in parenthesis is for directions for you only. Do not type your information in italics or in blue in your document. Please take further note that for legal forms the font Courier New as shown in the letter below is suggested, size 10, 11, or even 12 on standard sized white paper of 8.5" x 11" and with justified margins.

          The original notarized Waiver of Confidentiality should be placed with your original birth certificate at the Department of Health, then send copies to the state registrar, adoption agency, and the attorney who handled your adoption (if there was one). Also include a copy of your current birth certificate and driver's license or other legal identification. All of this should be done before you attempt to Petition the Court. However, in several states this Waiver is all you need for access to your records.

          A state-by-state listing of addresses for the Departments of Health can be found at this link: National Center for Health Statistics

          After you finish typing your Waiver, do NOT sign it until you are in front of a Notary Public (usually a free service at your bank). After notarization, make copies for the other agencies and an extra copy for your own records. Mail the Waivers with a return-receipt request so you will have records showing the date and name of the person who received it. Be sure to mail the original Waiver that you signed in front of a Notary to the Department of Health.

          Always submit a self-addressed-stamped envelope with your Waiver for them to send you your information in. You may also include a sealed envelope with a letter, pictures, etc. to be placed in your file and given to your birth family should they request information of you. You may also request in your Waiver your appreciation if they would forward the sealed letter to your birth family.

          If by chance you were born in one state and your adoption was finalized in another, submit your Waiver in both states. Make sure all your bases are covered. IMPORTANT: You are not required to sign a release form for this information. If they refuse your request without the release form, you can tell them that you will report them to the state licensing board and then follow through if they do not comply.

Waiver Example Letter PDF link: Waiver of Confidentially.pdf


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