DCS Consultation Information Sheet

Petitioner 1 Name(Required)

First Middle Last

Petitioner 1 Maiden Name

Petitioner 1 Gender

Petitioner 2 Name

First Middle Last

Petitioner 2 Maiden Name

Petitioner 2 Gender

Home Address(Required)

Street Address, City, State, ZIP & County

Are You Married, or Engaged to by Married?:(Required)

If your marital status changes at all during your adoption case you must let Grant Kirsh know immediately

Where/how Did You Hear About Kirsh & Kirsh?:(Required)

Annual Household Income:(Required)

If You Have Previously Adopted Who Was Your Attorney and in What Year Did You Adopt?(Required)

Have You Already Spoken With, or Hired, an Attorney? If So, Who?:(Required)

PETITIONER 1 INFORMATION:

Mobile #(Required)

Email(Required)

US Citizen or Green Card holder?(Required)

Employer:(Required)

Does your employer offer and adoption reimbursement? If so, how much?(Required)

PETITIONER 2 INFORMATION:

Mobile#

US Citizen or Green Card holder?

Employer:

Does your employer offer and adoption reimbursement? If so, how much?

DCS CASE INFORMATION

Number of Children to be Adopted(Required)

1st Child's Full Name(Required)

1st Child's Date of Birth(Required)

1st Child's Age(Required)

Please enter a number greater than or equal to 0.

2nd Child's Full Name(Required)

2nd Child's Date of Birth(Required)

2nd Child's Age(Required)

Please enter a number greater than or equal to 0.

3rd Child's Full Name(Required)

3rd Child's Date of Birth(Required)

2nd Child's Age(Required)

Please enter a number greater than or equal to 0.

Please Provide Name, DOB and Age of Other Children(Required)

County DCS case is out of:(Required)

Current Permanency Plan (adoption, reunification)(Required)

Has TPR been granted?(Required)

Has termination of parental rights (TPR) been filed?(Required)

Anything else you want us to know ahead of your consultation with Grant?

Comments

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