Post Adoption Self Report
Annual Report For Year
*
Please Select
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
Email
*
example@example.com
Child Information
Child's Adopted Name
*
First Name
Last Name
Child's Birth Name
*
First Name
Last Name
Date of Arrival in US
*
-
Month
-
Day
Year
Date of Birth
*
-
Month
-
Day
Year
Name of Adoptive Parents
*
First Name
Last Name
Family Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Physical Description & Health Status
*
Include height and weight, any significant illnesses, and well-child status.
Family Structure & Dynamics
*
Include parents' work routines, family lifestyle, describe child's relationships with parents and siblings.
Activities
*
Include sports, school, clubs, church, vacations, etc.
Emotional & Spiritual State of the children
*
Include sports, school, clubs, church, vacations, etc.
How are you keeping the child connected to their heritage?
*
How important events or comments
*
Please conclude with a positive statement about the country you adopted from.
Country you adopted from
*
Please Select
India
China
Bulgaria
Colombia
Ukraine
Ethiopia
Positive Statement
*
Please upload 3 to 5 good quality photos, unless you adopted from China (include 8 photos for China)
*
Upload Images
Drag and drop files here
Choose a file
Include one of the entire family, two with full views of just the child or children. DO NOT include photos containing children in costumes, children with food on their faces (BIRTHDAY CAKE, etc.), adults or children in skimpy clothes (bathing suits, short shorts, tank tops, etc.), and adults smoking or drinking alcohol.
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