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)

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)

Mobile#

US Citizen or Green Card holder?

Employer:

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

Number of Children to be Adopted(Required)

Age(s) of Child(ren):(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?

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