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ADULT CHILD REFERENCE
FAMILY'S NAME
(Required)
YOUR NAME
(Required)
First
Last
Phone Number
(Required)
Email
(Required)
A member of your family is applying to adopt a child. Gathering a reference from adult children is very important to the adoption process. The adoption process and the raising of children involve stress, patience, extensive teamwork as well as restrictions on personal freedom. Because of these factors, we would appreciate your objective input on this family's ability to pursue the adoption process. Please attach a separate sheet if necessary.
Describe your relationship with your parents.
Describe your parents' parenting skills and discipline techniques.
How do you feel your parents were as parents? What would you keep the same and what would you change?
Is there any history of family violence?
Yes
No
If yes, please explain.
Do you feel you have suffered any maltreatment from your parents?
Yes
No
If yes, please explain.
How often do you communicate with or see your parents?
Your overall recommendation regarding this family as prospective adoptive parent(s)
Highly recommend as prospective adoptive parent(s) without any reservations
Recommend as prospective adoptive parent(s), with limited reservations
Marginally recommend as prospective adoptive parent(s)
Definitely do not recommend as prospective adoptive parent(s), high reservations
If you have noted a concern, have you discussed this concern with the family?
Yes
No
Date
MM slash DD slash YYYY
Signature
When you complete the form please return it to Adoption & Beyond via e-mail address~ homestudy@adoption-beyond.org
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