Text Size:   A+ A- A   •   Text Only
Find     
Site Image

Non-Departmental Adoption Forms
Quick links
Non-Departmental Home
Non-Departmental Adoptions sample checklist

The following forms are needed when filing a private adoption petition. Each adoption category requires a particular form(s), so you need to print only those forms that apply to your adoption. For questions, please call 503-945-5670.


Face Sheet
PDF, Word
Recommended for all adoptions; to help streamline the adoption process.


Adoption Disclosure Statement
PDF, Word
List of expenses related to adoption. Required for all adoptions.


Voluntary Adoption Registry Notification Sample Form
PDF, Word
For all adoptions. Print the Voluntary Adoption Registry home page to comply with the notification requirement per ORS 109.353.


Genetic and Medical History of Child and Family (CF 246)
PDF, Word


Non-State Department of Human Services (CF 246A, Genetic/Medical History)
PDF, Word
Required for all adoptions (except step-parent adoption). To be used in conjunction with CF 246. Please fill out as completely as possible.


Adoption report
(PDF 12 KB): Information from the original certificate. Required for all adoptions.


Request for Oregon Criminal History Information
PDF, Word
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.


Request for FBI Criminal History Information
You can download the application form in PDF format or download the PDF form directly from the FBI website

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 who have resided in Oregon less than five years must submit a FBI criminal background check.

* View further instructions for obtaining a FBI background check.


Waiver of Home Study and Placement Report Form and Instructions
PDF, Word (Temporary Form)
Necessary when petitioner is requesting a waiver of the home study requirement. The Department has the authority to waive an adoption home study when (1) a biological or adoptive parent retains parental rights or (2) a petitioner qualifies as a relative as defined in Oregon Administrative Rules.


Request for Waiver of Independent Adoption Fees Statement of Household Earnings
PDF, Word


Affidavit Verifying Provision of Notice of Right to Payment for Adoption-Related Counseling Pursuant to ORS 109.346
PDF, Word
For most categories of adoption, except those listed here.


Notice of Right to Payment for Adoption-Related Counseling
PDF, Word


Private Agency and Independent Adoption Disruption/Dissolution Report
Only for the use of private adoption agencies to report an adoption disruption or dissolution.
PDFWord

​​​​​ ​​​​​​​