Home > Forms Library > Post Adoption
Parental Post Placement Report
 
Country: *
Todays Date: *
Name of Child: *
Original Name of Child:
Parent(s) Names:
Birth Date of Child:
Region of Orphanage:
Date of Adoption / Court Date:
Current Height:
Current Weight:
Current with Immunizations?: *
Is your child in good health?: *
If the answer is No, please provide any Health / Medical Concerns and Explainations:
Attachment services?:
Early Intervention services?:
Occupational Therapy?:
Physical Therapy?:
Speech Therapy?:
Other?:
If Yes, please explain:
Does your child display any eating or sleeping concerns?:
If Yes, please explain:
Rolling over?:
Sitting on own?:
Crawling?:
Pulling self up / Standing?:
Walking?:
Drinking from Sippy Cup?:
Holding Utensils?:
Using Pincer Grasp?:
Extra Curicular Activities:
Language Development:
Social Adjustment / Behavior:
Relationship With Parents / Siblings:
Achievements and Milestones:
Do You need a Social Worker help call?:
If yes, what is your concern?:
E-mail Address: *
Attach a Photo File:
* Required
Forms Library Forms Library Home Russia Serbia China Kazakhstan Ukraine Post Placement Additional Information - Apply to Adopt - Attend a Seminar