Consent For Contact Page 2
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2In order to locate the correct adoption file, please assist us by completing the information below. If you do not know this
information, please write “unknown”.
______________________________________________________________________________________________
Adoptee’s name, birth date, city and state of birth
______________________________________________________________________________________________
All names used by birth mother at the time of the adoption (include middle and maiden name(s) and name of birth
father.)
______________________________________________________________________________________________
Full names of both adoptive parents
■ ■
Adoptees:
Please check the box if you also want to receive nonidentifying background information about
your birth parents.
■ ■
Birth Parents:
Please check the box if you also want to receive nonidentifying information about the family that
adopted your child.
Refer to Family Code Sections 8706; 8817 for a full description of nonidentifying information.
What Happens to the Consent
The consent may be sent directly to the adoption agency which handled the adoption, if known, or to
the Department’s Central Office: Adoptions Support Unit, Department of Social Services, 744 P Street,
M.S. 8-12-31, Sacramento, CA 95814. If the adoption was an independent (private) adoption, the consent will be
acknowledged and placed in the adoption file and you will be sent any available information you requested. If the
adoption was an agency adoption, the consent will be returned to you with the name and address of the correct agency
so you may send it directly to that agency.
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