Request Packet

**All photos of children on this page represent photos of children placed. These children are no longer available for adoption.**

INFORMATION PACKET REQUEST

Congratulations on taking the first steps of beginning your adoption journey. If, after receiving our packet, you wish to proceed with your adoption journey we would love to help you make your dreams of adopting a child come true.

Our FREE informational packet includes details about our services, credentials, each country’s adoption programs, fees, parent references, financial options and much more.

To get you started, please complete the form below completely and click the “Request” button. All information is completely confidential and is never shared outside of Compassionate Care without your written consent.

ALL FIELDS ARE REQUIRED IN ORDER FOR YOUR REQUEST TO BE PROCESSED.
IF NOT APPLICABLE PLEASE MARK "NONE" OR "N/A"

I/WE HAVE ACCEPTED AND BELIEVE THAT JESUS CHRIST IS LORD AND SAVIOR.* YES NO

CHURCH AFFILIATION:

NAME:*     HUSBAND:
                                                   LAST                                                FIRST                       AGE                 WIFE                            AGE
POSTAL ADDRESS:*
                                                          STREET                                                                     CITY                            STATE              ZIP CODE

EMAIL ADDRESS:* RETYPE EMAIL ADDRESS:

TELEPHONE: HOME* CELL WORK

BEST CONTACT TIME: CONTACT ME AT

HOW DID YOU HEAR ABOUT US?

HAVE YOU EVER BEEN ARRESTED? HUSBAND: YES NO WIFE: YES NO

DO YOU HAVE A CRIMINAL HISTORY
OF SEXUAL OR CHILD ABUSE? HUSBAND: YES NO WIFE: YES NO

DO YOU HAVE A CRIMINAL HISTORY
OF DOMESTIC VIOLENCE? HUSBAND: YES NO WIFE: YES NO

DO YOU HAVE A HISTORY OF SUBSTANCE
ABUSE? HUSBAND: YES NO WIFE: YES NO

IF YES TO ANY OF THE ABOVE QUESTIONS PLEASE EXPLAIN:

NAME, AGE AND RELATIONSHIP OF OTHERS LIVING IN YOUR HOME:

ANNUAL INCOME: HUSBAND: WIFE:

MARITAL STATUS:* IF MARRIED # OF YEARS

COUNTRY DESIRED:         DOMESTIC (USA)    CHINA      ESTONIA         HAITI

                                                           RUSSIA     UKRAINE     UNDECIDED

CHILD DESIRED: MALE FEMALE EITHER GENDER SIBLING GROUP SPECIAL NEEDS

CAUCASIAN AFRICAN AMERICAN BI-RACIAL HISPANIC ASIAN OTHER

AGE PREFERENCE

COMMENTS OR QUESTIONS: