How did you learn about ASA?
Is there anything you would like to share about yourself or the child/children you seek to adopt?
Managing an emotional or mental health issue is not a deterrent to adoption. If you have a mental or emotional diagnosis, please secure a letter from your doctor advising of your ability to parent a child with your therapeutic protocol highlighted.
We thank you for your honest responses to this questionnaire. Your answers will be held in confidence by the owner of ASA and will only be shared with an adoption professional if this information is requested.
If yes, when was your last evaluation?
Why do you seek to adopt?
When will insurance coverage begin for your adopted child?
Full Open Adoption: Willing to communicate directly with a birth family through letters, pictures, phone calls, and possible visits; willing to give your last name and place of residence.
Semi-Open Adoption: Willing to communicate with the birth family through the agency by sending pictures of your child to the birth family via the agency without revealing any identifying information.
Closed Adoption: NO communication with the birth family, thus closing the door for future medical history.
Are there any limitations or concerns regarding travel?
Are you interested in learning more about international adoptions?
Are there any legal or financial concerns you have at this time?
Please list any other races here.
Please list any special needs you are willing to consider. Are you interested in more information related to special needs?