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Non-Departmental Adoption Forms

The following forms may be filed at the same time as a Non-Departmental adoption petition. Each adoption category requires a particular form, so print and submit only those forms that apply to your adoption. For questions, please call (503) 945-5670


  
Description
Face Sheet DHS 0213
Cover sheet for adoption packet. Recommended for all adoptions
Adoption Disclosure Statement
List of expenses related to adoption submitted to the court and DHS. Required for all adoptions.
Genetic and Medical History of Child and Family (CF 246)
Per ORS 109.342, required for all adoptions, except step-parent adoption. Submit form to the court and DHS.
Non-State Department of Human Services (CF 246A, Genetic/Medical History)
Required for all adoptions, except step-parent adoption. To be used with Genetic and Medical History of Child and Family. Submit form to the court and DHS.
Adoption Report
Required for all adoptions. Submit form to the court and DHS.
Voluntary Adoption Registry Notification Sample Form
Applies to most adoptions.

Print the Voluntary Adoption Registry web page to comply with the notification requirement per ORS 109.353. Provide to the court and DHS.

Request for Oregon Criminal History Information
Criminal History forms are necessary for waiver of home study requirement in relative adoptions or adoptions in which a biological or adoptive parent retains parental rights.

Petitioner and all adult household members must submit to a criminal background check. Per Oregon Administrative Rule 413-140-0065, only a biological parent is exempt from a criminal background check. Results are submitted to DHS​.

Request for FBI Criminal History Information
Criminal History forms are necessary for waiver of home study requirement in relative adoptions or adoptions in which a biological or adoptive parent retains parental rights.

Petitioner and all adult household members (except biological parent) who have resided in Oregon less than five years must submit a FBI criminal background check. Results are submitted to DHS. View further instructions for obtaining a FBI background check.

Waiver of Home Study and Placement Report Form and Instructions
(Temporary Form) Necessary when petitioner is requesting a waiver of the home study requirement. Provide form to the court & DHS. The Department has the authority to waive an adoption home study when:
  • a biological or adoptive parent retains parental rights or
  • a petitioner qualifies as a relative as defined in Oregon Administrative Rules.
Request for Waiver of Independent Adoption Fees Statement of Household Earnings
Applies to adoptions that require a placement report. Petitioner must submit form to the Department when requesting waiver or reduction of the $800 placement report fee.
Notice of Right to Payment for Adoption-Related Counseling
Private Agency and Independent Adoption Disruption/Dissolution Report
Only for the use of private adoption agencies to report an adoption disruption or dissolution.