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Application To Place Unborn Child For Adoption 20.03 - Ohio
| Application To Place Unborn Child For Adoption Form. This is a Ohio form and can be used in Adoption Probate Lucas County (Court Of Common Pleas) . |
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PROBATE COURT OF LUCAS COUNTY, OHIO JUDGE JACK R. PUFFENBERGER IN RE: CASE NO. _______________ INFANT ________________________ APPLICATION TO PLACE UNBORN CHILD FOR ADOPTION Now comes ________________________________, the birth parent of a presently unborn child and states that she/he is _____ years old. Birth mother also believes ______________________________________ to be the birth father. Child is due to be born about ______________________ at _______________________Ho spital. Birth parent is aware that Court requires a Mandatory Assessment to be completed by a Court-Appointed Assessor and agrees to said requirement. Birth parent further states that she/he is aware that prior to the Placement Hearing, all medical records regarding the infant and the birth parent(s) shall be provided to the attorney representing the prospective adoptive applicant(s). Birth parent is also aware that this Placement Hearing must be held anytime after 72 hours from the time of the infants birth. She/he further states that she/he is aware of his/her right to contest the decree of adoption subject to the limitations of Section 3107.16 of the Ohio Revised Code. Birth parent further authorizes the Court to order the hospital to release said child to foster care prior to the Courts Placement hearing. ______________________________ Attorney for Birth Mother ______________________________ ______________________________ Birth Mother B irth Father ______________________________ ______________________________ Address Address ______________________________ ______________________________ ______________________________ ______________________________ Phone No. Phone No. LCPC Form 20.3 American LegalNet, Inc. www.USCourtForms.com
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