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    In The Matter of The Adoption Of: and Concerning

    Uploaded by

    Steve
    This document is a consent form for contact between an adopted person and their biological family. It contains fields for the adopted person's name and relationship to the person they want to contact. They can choose to consent to contact through correspondence, phone calls, or meetings. Alternatively, they can refuse contact and choose to keep their records sealed. The form requires signatures from the adopted person and the confidential intermediary, and certification that the court received a copy.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    In The Matter of The Adoption Of: and Concerning

    Uploaded by

    Steve
    54 views1 page
    This document is a consent form for contact between an adopted person and their biological family. It contains fields for the adopted person's name and relationship to the person they want to contact. They can choose to consent to contact through correspondence, phone calls, or meetings. Alternatively, they can refuse contact and choose to keep their records sealed. The form requires signatures from the adopted person and the confidential intermediary, and certification that the court received a copy.

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    jdf346.doc

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    This document is a consent form for contact between an adopted person and their biological family. It contains fields for the adopted person's name and relationship to the person they want to contact. They can choose to consent to contact through correspondence, phone calls, or meetings. Alternatively, they can refuse contact and choose to keep their records sealed. The form requires signatures from the adopted person and the confidential intermediary, and certification that the court received a copy.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    54 views1 page

    In The Matter of The Adoption Of: and Concerning

    Uploaded by

    Steve
    This document is a consent form for contact between an adopted person and their biological family. It contains fields for the adopted person's name and relationship to the person they want to contact. They can choose to consent to contact through correspondence, phone calls, or meetings. Alternatively, they can refuse contact and choose to keep their records sealed. The form requires signatures from the adopted person and the confidential intermediary, and certification that the court received a copy.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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     District Court  Denver Juvenile Court

    _________________________________________ County, Colorado


    Court Address:

    IN THE MATTER OF THE ADOPTION OF:

    AND CONCERNING:

    , Petitioner
    COURT USE ONLY
    Attorney or Party Without Attorney (Name and Address): Case Number:

    Phone Number: E-mail:


    FAX Number: Atty. Reg.#: Division Courtroom
    CONSENT RELEASE OR REFUSAL TO CONTACT

    I, __________________________________________________________________________, CONSENT TO CONTACT


    with my _________________________________________________________________________________(relationship).
    My legal name is: _____________________
    My legal birth name was: Date of Birth: _______
    I agree to the following form of contact:
     exchange of correspondence  telephone call
     personal meeting  other (specify) _________________________________________

    I state that my consent is voluntary and informed, and I release the confidential intermediary, the training organization, the
    Court and any agency from any liability resulting from this contact.

    ___________________________________________________ ___________________________________________
    Signed Date Confidential Intermediary Date

    _________________________________________________________________________________________________________________________________
    Address of Signatory

    I, _______________________________________________________________________________, REFUSE CONTACT


    with my __________________________________________________________________________________(relationship).

    My current legal name is: ____________________


    My legal birth name was: Date of Birth:

    I acknowledge receipt of information about the Colorado Voluntary Adoption Registry for my use in the event I should ever
    desire to have contact with this individual. It is my present desire that the records remain sealed and my anonymity be
    preserved.

    _____________________________________________ ___________________________________________
    Signed Date Confidential Intermediary Date

    _________________________________________________________________________________________________________________________________
    Address of Signatory

    I certify that a signed copy of this Consent Release or Refusal to Contact was received in the __________________Court,
    ________________County, Colorado.
    _____________________________________________ ___________________________________________
    Date Signature of Clerk
    JDF 346 R9/00 CONSENT RELEASE OR REFUSAL TO CONTACT

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