Birth Father'S Adoption Plan (Page 4 of 5) in pdf

Birth Father'S Adoption Plan Page 4

Do you know whether the adoptive parent(s) have any health conditions that may shorten

their life expectancy or curtail normal daily activities? Yes

Do you know whether the adoptive parent(s) have been convicted of any crimes other than

minor traffic violations? Yes

Do you know whether any child of the adoptive parent(s) has ever been removed due to

allegations of child abuse or neglect against him/her/them? Yes

Do you have preference regarding the religious practice of the adoptive family for your child?

Yes

If yes, please specify what religion you prefer_______________________________

Would you object to your child being placed with a family whose religion is different from your

own? Yes

there additional information you want about the adoptive parents? Yes

If yes, please specify___________________________________________________

____________________________________________________________________

Knowing all of the above information about the adoptive parent(s), do you still want

them to adopt your child? Yes

Uncertain

Have the adoptive parent(s) or anyone acting on their behalf (agency, attorney, facilitator)

paid or offered to pay directly to you or indirectly to a third party (landlord, creditor, doctor,

hospital, attorney, agency, facilitator) any money or thing of value?

Yes

If yes, please give details of who paid, how much, recipient and purpose:

__________________________________________________________________________

Birth Father'S Adoption Plan Page 4