Application Forms

Applicants are encouraged to read the Fact Sheet (form #824) to determine eligibility for services. The application packet can be processed by the Department of Human Resources when the following documents are provided:
  1. A completed/signed application form;
  2. A notarized consent form;
  3. The statistical survey, and
  4. A copy of photo identification with a signature.
The type of consent form needed will depend upon if the applicant is an adult adoptee, birth parent, or sibling.
Adult Adoptee Birth Relatives – Parens or Siblings
Document Name Form Number Document Name Form Number
Fact Sheet 824 Fact Sheet 824
Reference – Search Support Groups Reference – Search Support Groups
Reference – The Girls Who Went Away Reference – The Girls Who Went Away
Application Form 2062 Application Form 2062
Consent Form – Adult Adoptee 2064 Consent Form – Birth Parent 2063
Statistical Survey 2066 Statistical Survey 2066
Adult Adoptee Disclosure Veto 2071 Birth Parent Disclosure Veto 2072
Other forms available are: Disclosure Vetoes Forms, which are for those wishing to declare their intention should their birth relative, seek to establish contact. The Fee Waiver Form is only required if the assigned Confidential Intermediary is from a private agency. This will not be known until the application is processed and the search is assigned. These are forms that are for Confidential Intermediaries, to be used when providing ASCRS.
Confidential Intermediary Forms
Document Name Form Number
Birth Certificate Application DHMH
Death Certificate Application DHMH
CI Agreement/Service Agreement 2070
Pre-Search Questionnaire – Adoptee 2067
Pre-Search Questionnaire – Birth Parent 2068
CI Outcome Report 2073
Client Satisfaction Survey 2074
Application Form Committed Youth 2088
Consent Form Committed Youth 2090
CI Outcome Report Committed Youth 2092
Information on Birth Family 2069
CI Qualifications & Requirements 2078
CI Code of Ethics & Oath of Confidentiality 2076
CI Ethics & Oath Voluntary 2077
To receive a copy of the application documents, send an email to or call 410-767-7171. Information requested:
  1. name
  2. status: adoptee or birth relative
  3. phone number
  4. mailing address
Questions / concerns about ASCRS or the process, Contact Jeffrey O’Donnell at the Department of Human Resources, Social Services Administration. Jeffrey O’Donnell, LCSW-C 410-767-7171 Department of Human Resources Social Services Administration Adoption Search Contact and Reunion Services 311 West Saratoga Street Baltimore, Maryland 21201