Information Request Form

In the case of an adult adopted individual wanting to request information related to his adoption, the following form has to be completed and submitted.

Extracted Text for Proper Search

KentuckyUnbridledSpirit.com	
Kentucky Cabinet for Health and Family Services
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Kentucky’s Adoption
Search Services	Kentucky Cabinet for Health and Family Services	
Department for Community Based Services

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Beginning a search
for adoption information	
Adoption brings with it an array of feelings for a new family:
happiness, fulfillment and hope. Paired with that optimism may be
feelings of concern for adopted persons once they become adults and
have questions about their birth families.
Adopted persons may want to learn more about their birth families
for many personal reasons. Siblings of adopted persons may also
want to find information about their brothers and sisters.
This guide is intended to assist those adults who seek background
information about themselves or their birth siblings.
The Kentucky Cabinet for Health and Family Services may be
able to help adult adopted persons whose adoptions were finalized in
a Kentucky	
 circuit or family court begin a search for information.
Adoption records are sealed once the courts finalize an adoption
and can only be opened by court order. Kentucky law requires the
cabinet, private adoption agencies and state courts to release certain
information when certain conditions are met.	
Who can get adoption information?	
With some conditions, the cabinet may be able to help people in
the following circumstances:
„ When an adopted person at least 21 years old is seeking health
and background information about birth parents
„ When an adopted person at least 21 seeks identifying informa-
tion about birth parents and
„ When a birth sibling seeks information about an adopted brother
or sister when both parties are at least 18	
Table of Contents	Beginning a search for adoption information...............1
Who can get adoption information?.............................1
Adopted persons seeking health information...............2
Requesting information about a sibling........................2
How do I make a request?...........................................2
When the cabinet has health information.....................3
Adopted persons seeking identifying information.........3
Birth parent or relative requests...................................5
Further information.......................................................5
Biological Parent Consent Form..................................6
Information Request Form...........................................6

Adopted persons seeking
health information	
Adopted persons who are 21 or older can make a written
request to the cabinet for nonidentifying health and background
information about their birth parents.
The following information may be disclosed from adoption
records:
· Information about the health history of the biological par-
ents and other relatives that could affect the adopted
person’s mental or physical health and
· Cultural and background information about the adopted
person’s birth parents and other relatives	
Requesting information about a sibling	
Siblings can receive information about a birth brother or sister if
the following conditions are met:
· Siblings had a relationship prior to the adoption.
· Both siblings are 18 or older.
· Both siblings make similar requests.
· The adopted person’s file contains similar requests for infor-
mation and/or contact between adult siblings.	
How do I make a request?	
Adopted persons must request nonidentifying information from
the cabinet in writing.
Be sure to clearly state the information or services requested,
sign the request and include the following information:
· Your full adoptive name and birth date
· Your adoptive parents’ full names
· The Kentucky county in which the adoption was finalized
· Your biological parents’ names, if known
· Your Social Security number
· Your current name, address and phone number and
· A copy of a valid, government-issued photo identification card.Or, complete the request form on page 7 of this booklet and 	
send	
it with a photocopy of a valid, government-issued photo identification
card to listed address.
The cabinet receives hundreds of requests for information per
year. Requests are processed in the order they are received.	When the cabinet has
health information	
If the cabinet receives written, physician-verified information from
a birth parent, sibling or a medical service provider about a medical or
genetic condition that may affect the physical or mental health of an
adopted person, the cabinet will make diligent efforts to notify:
· The adult adopted person
· The adult whose parental rights have been terminated by a
Kentucky court or
· An adoptive parent of a child.
The cabinet will also submit the health information to the court that
issued the adoption order to be placed in the court’s records.
If a private adoption agency or the court receives health informa-
tion about a birth relative of an adopted person, they are required to
submit the information to the cabinet to be placed in the adopted
person’s file.	
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Adopted persons seeking
identifying information	
Adopted persons who are at least 21 may request identifying
information about their birth parents if the following conditions are
met:
· The adopted person obtains a court order from the circuit or
family court in the county in which the adoption was finalized.
· The adopted person receives a letter to send a $150 fee to the
cabinet to complete the search.
To apply for a court order: The adoptee must file an AOC 290
form (Petition to Inspect Adoption Records) with the Kentucky circuit
or family court in the county where the adoption was finalized. Two
forms of identification are required upon filing.

To pay the fee: Mail a money order or check payable to the
Kentucky State Treasurer to this address:
Kentucky Cabinet for Health and Family Services
275 E. Main St., 3C-E
Frankfort, KY 40621
Once the request is filed, the cabinet has six months to conduct
the birth parent search.
If the birth parents are located:
„ They have two months to provide the cabinet with written
consent or denial of consent for the release of identifying
information and
„ The cabinet will not share the adult adopted person’s identity or
contact information, which is considered confidential.
If the birth parents cannot be located or are deceased, the court
may still order the release of certain information from an adoption file.
In order for the cabinet to release a copy of an original birth certifi-
cate, the judge must specifically order the Office of Vital Statistics to
release it by sending a court order to that office.
Adult adopted persons who have a change of address or tele-
phone number before the search is completed must provide the
cabinet and the court with updated contact information.	
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Birth parent or relative requests	
By Kentucky law, the cabinet cannot conduct searches for
adopted persons that are initiated by birth parents or relatives.
Birth parents and preadoptive siblings are encouraged to provide
name changes, current addresses and current phone numbers to the
cabinet, the court, or a private adoption agency to be place in the
closed adoption record.
Birth parents are encouraged to notify the cabinet about any
significant family medical or health issue that is verified by a physi-
cian. The cabinet will make diligent efforts to contact the adult
adopted person to relay the information as well as place the informa-
tion in the adopted person’s closed file.
Birth parents may complete the consent form on page 6 of this
booklet and return it to the cabinet to be placed in the adopted
person’s file.	
Further information	
Read the Kentucky laws regarding adoptee searches under KRS
chapter 199 online at http://www.lrc.state.ky.us/krs/199-00/
chapter.htm.
To speak to cabinet staff about an adoption search, call (502) 564-
2147 or your local Department for Community Based Services office.
For additional information regarding adoptions, contact:
National Adoption Information Clearinghouse
330 C St., SW
Washington, DC 20447
Phone: (703) 352-3488 or (888) 251-0075
Fax: (703) 385-3206
Web site: http://naic.acf.hhs.gov
e-mail: [email protected]

Biological Parent Consent Form	
Please place this consent form in my birth child’s adoption file:
I, _______________________________________________, as biological
mother/father of ______________________, born on _________________
  Consent         Do not consent
to the aforementioned child, upon reaching adulthood, being allowed to
inspect the adoption records pertaining to him/her. I understand that under
current law, personal contact information will not be released by the Circuit
Court or the Cabinet for Health and Family Services without a court order.
Also, I
Consent         Do not consent
to the child having personal contact with me upon reaching adulthood. I
understand that under current law, personal contact information will not be
released by the Circuit Court or the Cabinet for Health and Family Services
without a court order.
I understand that copies of this document will be filed in the records of the
Cabinet for Health and Family Services and in the circuit court records of the
adoption. I also understand that this consent/denial of consent is valid until
revoked or altered by me.
Name: ______________________________________________________
Address: ____________________________________________________
City/State/ Zip: _______________________________________________
Phone number with area code: __________________________________
E-mail address:	
 ______________________________________________
Social Security number: _______________________________________
Signature and date: ___________________________________________	
Please notify the Cabinet for Health and Family Services	
with any address or phone number changes	
Information Request Form	
Adult adopted persons may request information by completing this
form and sending it with a copy of a valid, government -issued photo
identification card to the following address:	
Kentucky Cabinet for Health and Family Services
275 E. Main St., 3C-E
Frankfort, KY 40621
(502) 564-2147
____________________________________________________________
Adoptive name
_______________________     _______________________________
Adopted person’s birth date     Social Security number
____________________________________________________________
Adoptive parents’ names
____________________________________________________________
County of adoptive parents’ residence at time of adoption
____________________________________________________________
Birth parents’ names, if known
____________________________________________________________
Your current name
____________________________________________________________
Your current address
____________________________________________________________
_____________________________    _____________________________
Your current phone with area code   Your e-mail address
____________________________________________________________
Your signature
Nature of request:_____________________________________________
_____________________________________________________________	
Revised February 2005
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