In navigating the complexities surrounding adoption records in New York State, the DOH-30 form serves as a crucial tool for adoptees seeking to unearth their biological heritage. Administered by the New York State Department of Health Adoption Information Registry, this application is the gateway to accessing a range of information from non-identifying general and medical details about biological parents—as available at the time of adoption—to identifying information regarding biological parents and siblings, contingent upon their registration with the registry. It emphasizes the necessity for an adoptee to be at least 18 years of age to request identifying details, although non-identifying medical information is accessible with no age restriction, provided an adoptive parent consents for those under 18. The DOH-30 form mandates thorough completion, and the inclusion of an adoptee's birth certificate and adoption order—if accessible—to avoid delays in processing. Moreover, it addresses the potential involvement of an adoption agency by offering the applicant the choice to either receive information directly from the agency or via the Department of Health. The procedural nuances of the form underscore the New York State's commitment to facilitating adoptees' quest for personal history while rigorously safeguarding the privacy of all parties involved.
| Question | Answer |
|---|---|
| Form Name | Form Doh 30 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | wdh30m adoption information registry new york 800 |
New York State Department of Health
COMPLETE THIS APPLICATION
AND RETURN TO:
New York State Department of Health Adoption Information Registry
P.O. Box 2602
Albany, New York
REGISTRY NUMBER
DATE
OFFICIAL USE ONLY
NOTE: This registration can be accepted only if the adoptee was born and adopted in New York State. Complete as much information as possible and include a copy of adoptee's birth certificate and adoption order, if available.
Please indicate if this registration is for: (check all that apply)
Identifying information (***) - About biological parents, if/when registered.
Identifying Information (***) - About biological siblings, if/when registered.
(*)Adoptee must be 18 years of age or older.
(**) No age restriction, but adoptive parent must sign this registration, if adoptee is under 18 years of age.
(***)Adoptee must be 18 years of age or older. Unless this box is checked, you will not be notified of a match even if your birth parents or biological siblings are registered.
Note: If the Adoption Registry determines that an agency was involved in your adoption,
Check box, if you do not want the information released by the agency that handled your adoption. If the box is checked, the New York State Department of Health will obtain the information from the agency and share it with you.
PLEASE COMPLETE ALL INFORMATION. MISSING INFORMATION MAY DELAY PROCESSING. 1. Name and address of adoptee
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2.Date of birth of adoptee
3.Adoptive parents
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A. MOTHER: |
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B. FATHER: |
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C. ADDRESS AT TIME OF ADOPTION, if known |
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4. Place of birth of adoptee
HOSPITAL, if known
CITY, TOWN OR VILLAGE |
COUNTY/BOROUGH |
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5.Indicate the name of the agency and court of adoption, if known
A.NAME OF AGENCY
CITY, TOWN OR VILLAGE |
COUNTY/BOROUGH |
Check box if you have already received
Date received:
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C. DATE OF ADOPTION |
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B. NAME OF COURT |
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6. Is the adoptee in contact with birth brother(s) and/or sister(s)?
YES
NO If yes, please provide the following information for each sibling with whom adoptee is in contact.
NAME
DATE OF BIRTH
ADDRESS (include zip code)
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7. Signature and Notarization. |
heg |
State of
County of
SS.
I solemnly attest that all of the information provided on this application is true and accurate to the best of my knowledge under the penalty of perjury.
SIGNATURE OF REGISTRANT
Signature must be notarized
NOTE: Adoptive Parent must sign if the adoptee is under 18 years of age. Notarization must include Notary's stamp or raised seal.
Sworn to before me this |
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Notary Public |
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