Questionnaire

InfoAdopt.com 

Adopt Now - Adopt With Confidence   

[ Services ] [ Questionnaire ] [ About Us ] [ Contact Us ]

 

 

Adoption Needs and Desires Questionnaire

 

 

    

What type of child to you wish to adopt?
Age Range:
Strong sex preference:
Racial makeup (may select more than one):  

     

 Caucasian

Hispanic
Asian
American Indian
African American
Caucasian Mix (anything but African American)
Bi-racial (AA and Caucasian mix)
When will you start your adoption process?
What is your complete adoption budget?
What is your current income?
Do you have a completed home study at this point?
What is your religious background?
Do you have health insurance?
Do you have life insurance?
Do you own your own home?
Length of Marriage?
Has either partner been previously married?
Education Level
     Husband
     Wife
Do you have confirmed medical infertility?
Do you have children now?      Yes-Adopted
     Yes-Biological
     No
Do you have American Indian heritage?  If so, what Tribe?
Will one or both parents stay at home with child?
Are you willing to travel to another state for the adoption placement?
Are you comfortable with the idea of speaking via telephone or meeting the birthmother during pregnancy?
Would you like to be present at the birth if she wishes you to?
After birth would you send pictures to the birthmother directly or through an agency?
What do you think is your number one priority in this process?
     Other.  Please Describe.

 

 

 

 

Tell us how to get in touch with you:

 

Name

E-mail

Tel

FAX

Please contact me as soon as possible regarding this matter.

 

 

 

Copyright © [2003]  Adoption Information Connection L.L.C.