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If you have surrendered your infant, help your baby by providing some health
information and some family background. Again, no information is required
from you by law. However if you can give it, this information will be very
important to your child in his or her future. It is also very helpful for
their adoptive family. This information will be used only for this purpose.
It will not be used to identify you or find you.
Either provide this information during a surrender, or send it later to
the county department of social services.
You may not know all the answers – that’s okay. Please just
provide your baby with as much information as you do know.
- What is the date of birth?
- Was the baby premature?
- Were there any problems with the pregnancy or
deliver? If so, what were they?
- Did you smoke, use alcohol, drugs or any
medication during pregnancy? If so, please provide details about what and
how much.
- Do you have any medical conditions such as diabetes, asthma, allergies,
seizures, cancer, heart disease, high blood pressure or mental illness?
- Does
the baby’s father have any of these conditions?
- What is your age?
- What is your race?
- What is the father’s age?
- What is the father’s race?
- Please feel free to include a note to
your baby, or to the people who will adopt your child.
This history is a thoughtful gift for your child. Thank you.
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