IAAME MONTHLY REPORTS

Department of State's Case Detail Verification

This data is required by the Department of State for each child adopted to the United States. The collected data is aggregated and submitted to United State's Congress in an Annual Report in a non-identifying report. IAAME collects this data on behalf of the Department of State and is obliged to safeguard your family's confidentiality. If you have any questions you may contact janelle@hopscotchadoptions.org
In an effort to be timely and accurate, please complete this survey for each child you have most recently adopted within 5 BUSINESS DAYS. We are grateful to each of you for your participation in this mandatory report to the Department of State. We love working with your lovely family!
Name of Parent #1*

First NameLast Name
Parent #1 Date of Birth*

MonthDayYear
Date
Name of Parent #2 If Applicable

First NameLast Name
Parent #2 Date of Birth If Applicable

MonthDayYear
Date
Enter The Date You Were Accepted Into The Hopscotch Country Program*

MonthDayYear
Enter Your City of Residence's Name:*
Choose Your State of Residence:*
Which Country Do You Reside In: *
What Country Did You Adopt From:*
What Country Did You Adopt From:*
Choose one response specific to this adoption.
Have You Previously Adopted From a Foreign Country?*
IF YES, Which Country Have You Most Previously Adopted From:
IF YES, What Is The Date of Your Most Recent Previous Adoption:

MonthDayYear
Enter a date to the best of your knowledge, if your child's adoption decree is not readily available.
Is Your Case A Transfer Case from A Different Primary Provider? Choose "NO"*
Enter The Approval Date Of Your Most Recent Home Study:*

MonthDayYear
Enter The Date Your Dossier Was Shipped Abroad:*

MonthDayYear
Enter Your Child's Referral Date:*

MonthDayYear
Enter The Date Your Child's Referral Was Given:*

MonthDayYear
*ENTER THE SAME DATE AS NOTED IN THE QUESTION ABOVE.
Enter Your Child's Birth Name *
Enter Your Child's Current Legal Name *
Enter Your Child's Date of Birth*

MonthDayYear
Date of birth listed on the child's original birth certificate
Choose Your Child's Gender:*

FEMALEMALE
Is Your Child A Biological Sibling To Another Child in This Specific Adoption:*

NOYES
Did You Act On Your Own Behalf: Choose "NO"*

NOYES
Enter The Name and Location of Your Child's Orphanage or Foster Family: *
Was Your Adoption a Kinship/Relative Adoption: Example a Niece or Nephew to Adoptive Parent.*
For This Adoption, Did You Adopt Unrelated Children? Example: If you adopted more than one child, and the children are not biologically related, choose "No".*
Is This Adoption an "Out of Birth Order Placement"? Example: 1. If you have children already in the home prior to this adoption, is the newly adopted child older than the children in the home? Choose "YES". This is considered to be an out of order placement. 2. If the newly adopted child is younger than any of the children in the home, choose "NO"*
Enter The Date You Took Legal Custody Of Your Child:*

MonthDayYear
Enter The Date Your Child's Adoption Was Finalized:*

MonthDayYear
Note Specific to families in the Morocco and Pakistan Programs: If your child entered the US under Guardianship or Kafala, enter the date of the Final Adoption Decree from the state you reside in.
Was Your Child's Adoption Finalized in the Foreign Country or In The United States*

Foreign CountryUnited States
If you have not yet submitted a copy of your child's Final Adoption Decree or Certificate of Citizenship, please upload a copy of these documents here. Hopscotch will keep each document on file in the event you require a readily available copy.

Please remember the submission of a scanned copy of these documents are a requirement previously noted within each family's service agreement.
Cancelof
Is your family in need of any additional support, services or resources? *

YESNO
Name of Your Home Study Agency
Address of Your Home Study Agency

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of Your Home Study Agency
Please enter a valid phone number.
Name of Your Home Study Worker

First NameLast Name
Finally, please enter your Home Study Social Worker's email address:*
example@example.com
Should be Empty:

Department of State's Case Detail Verification