Adoption Search and Reunion

Forms and Sample Letters

Remember that sample letters are just that and will work best if you put them into your own words. Also see my first contact page for more help on the subject

When a birth mom receives a private letter from you or is approached by a third party asking her to consider reunion with you, it gives her time to think it all through. She can take some time to work through her past and be ready then to accept you into her life. The point is that by being respectful of your birth mom it can also help to gain the reunion you really are looking for.

The idea for the adoptee in writing first contact letters is to let the person know who you are without giving it all away to someone else who may find the letter and read it. With that in mind, I offer these sample letters.

Always include your full name, address or PO Box, a phone number and email address. Many people send a SASE and say that they will accept a collect call.

Adoptee's First Contact letter to Birth Mom


Here is another sample

Adoptee's First Contact Genealogy Letter to possible Birthdad
may also be used for Birthmom

BirthMom's letters to Adoptee

The situation is different for the Birth Mom trying to write to the adoptee. If at all possible try to find out from the adoption agency if the adoptive family had been advised to tell the adoptee that they were adopted. Since the mid 60's most agencies did advise the parents to do this. Of course that does not mean that they did. If their families believed that the child should not be told, they may have listened to this advise instead.


Health History Form

Has been moved to it's own page to make it easier for you to copy/paste or print it off. You will find it

Letter to Hospital to Request Medical records

You must know your birthname in order to use this:

I am requesting my medical records. I was born in (name of hospital) on (your birthdate). My name at birth was (birth name) and I was born to (birth mother's name). {If you don't know your birth mother's name just delete that last part and this next sentence.} My doctor advised that I request records for both of us. The attending physician was (doctor's name, if you know it). I realize that my records may have been microfilmed. Please let me know if there is a fee so that I can forward it to you. I have enclosed a self-addressed stamped envelope for your convenience. Thank you! Remember to use your birth name and current last name on the return envelope. The postal carrier will usually deliver when just the first name differs.


Birth mothers can get these records at any time. Don't mention that the child was adopted. If you do not know the exact Date of birth you can avoid giving the exact DOB by requesting your records from your hospital stay and give the approximate dates you were in the hospital. By stating it that way, you give yourself room for error. I know a BirthMom who had gone into labor on the 19th of the month and had forgotten that the birth was after midnight. It is very easy to have the date wrong.

If your hospital stay was paid for by the adoptive parents you can hope that the record will include that information. Pray for the name to show up on your record.

Waiver letters

It is a good idea to file a Waiver letter with the agency of adoption and/or the state dept that is in charge of releasing identifying information. These letters must be notarized.

Waiver of Confidentiality
authorizing release of information from a birth parent's agency file.

**OPTIONAL: I hereby submit (documents, history, record, paternity order, photos) to be added to my child's file, the same to be shared with him/her upon request.

**OPTIONAL: permission is granted, but limited to medical information supplied herein to be shared with the adoptive parents of said child for the overall of my child in minority or majority. This includes the right of the agency to make contact with me for up-dates or added information that the adoptee or adoptive parents may request.

**OPTIONAL: This waiver of confidentiality and right to privacy is also extended to (the adoptive parents of said child) (siblings of said child).



Waiver of Confidentiality
authorizing release of information from an adoptee's agency file.

    This Waiver of Confidentiality Applies to the Following Information as I know it to be True:

    Birth Name :
    Adoptive Name :
    Date Of Birth :
    Hospital Of Birth :
    City and State of Birth :

    To Whom it May Concern :

    I wish this letter to be placed in any file(s) held by your agency concerning my adoption and used as authorization to waive the confidentiality guaranteed me under law. This includes the release of any agency records, hospital records, court records, and records surrounding my birth and adoption, including " identifying information".

    Further, upon request from either of my birthparents ( or siblings, grandparents, or other requesting relatives), I wish a photocopy of this letter sent or given to (him/her/them) and recognize this letter to be my consent and authorization thereto. I also request notification should one or both of my birthparents or birth relatives request this information.

    I authorize to waive the confidentiality guaranteed me under law.

    Please send a letter informing me of your agency's intent to recognize this waiver and, if I am refused, please site the state law that prohibits such recognition. If your state requires a specific form for this waiver, please include all necessary information.




return to Adoption Search and Reunion

    Before emailing for help, please read my search tips and use the resources on my website. It took me over six months to write all this.
    I can't answer questions and put all this into an email.. {:-)~[


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