Adoption Consent Form

NEW HAMPSHIRE ADOPTION CONSENT — PREPARATION CHECKLIST

NOT AN ADOPTION CONSENT

Do not sign or file this checklist. Use it to select the current route and
form, assemble the required people and records, and give New Hampshire adoption
counsel completion instructions.

1. Adoption and court route

Select every possible route or complication for counsel review:

☐ Private placement or direct adoption

☐ Licensed agency or department involvement

☐ Stepparent, relative, or guardian adoption

☐ Adult adoption or another route requiring a different instrument

☐ Interstate placement or out-of-state signer

☐ Child-custody jurisdiction or another state/country order

☐ Indian-child, tribal, ancestry, membership, or eligibility issue

☐ Assisted reproduction, surrogacy, parentage, or donor issue

☐ Unknown, alleged, putative, adjudicated, or disputed parent

☐ Minor, incapacitated, missing, deceased, or unavailable signer

☐ Consent may be unnecessary, implied, withheld, or subject to court action

2. Required-person and status map

Do not assume that a person described informally as a “birth parent” is the only
person whose consent, notice, relinquishment, waiver, or court determination is
required.

Parentage and notice search completed: [________________________________]

Court findings or orders needed before consent: [________________________________]

3. Current-law and official-form register

☐ Current official forms were downloaded fresh for this matter

☐ Current statutes, court rules, orders, and controlling cases were checked

☐ Pending and recently effective changes were checked

☐ The selected form matches this signer, route, child, and court

4. Timing, execution, and withdrawal workpaper

Do not use one generic 72-hour or five-day rule. Calculate each event from the
current authority that applies to the selected signer and route.

Calendar owner and independent review: [________________________________]

Do not state that a consent is immediately effective, automatically final,
freely revocable, or irrevocable except for fraud or duress without the exact
current source and facts.

5. Advice, voluntariness, capacity, and communication

Private payment, benefit, expense, or consideration issue requiring separate review:
[________________________________]

6. Form contents and attachment checklist

Confirm the selected current form addresses every item required for the route.
Do not add homemade language where the form or statute supplies prescribed text.

☐ Correct signer identity, capacity, address, and relationship

☐ Child identity, birth information, residence, and current placement

☐ Proposed adoptive parent, agency, recipient, or permitted identity treatment

☐ Parentage, other-parent, notice, and existing-order information

☐ Voluntariness, advisements, consequences, and alternatives

☐ Route-specific consent, surrender, relinquishment, or waiver language

☐ Withdrawal, challenge, and court-contact information

☐ Witness, oath, acknowledgment, notary, or judicial language

☐ Medical, social, genetic, ancestry, family-history, and identifying records

☐ Agency, department, interstate, tribal, or federal documentation

☐ Counsel, counselor, guardian, interpreter, or representative certificate

☐ Additional court form or attachment: [________________________________]

7. Execution and filing plan

8. Terms not to import into the consent

An adoption consent is not a private commercial settlement. Do not add:

• consideration recitals or a bargain with prospective adoptive parents;
• representations and warranties that survive a decree;
• covenants not to contest, cooperate, or maintain confidentiality;
• default, cure, specific-performance, injunction, damages, or fee provisions;
• indemnity, release, liability cap, or force-majeure terms;
• arbitration, forum selection, jury waiver, or dispute-resolution boilerplate;
• assignment, successors, integration, severability, or reformation terms;
• counterpart, electronic-signature, facsimile-original, or delivery rules;
• a private revocation form, period, or notice route; or
• a signature or clerk-acceptance block copied from another jurisdiction.

Any permissible contact agreement, expense arrangement, agency document,
custody instrument, or court filing must be prepared and reviewed separately.

9. Final review

☐ Correct adoption route, court, location, and case identified

☐ Every required person and notice recipient analyzed

☐ Current signer- and route-specific official form selected

☐ Timing and withdrawal calculations independently reviewed

☐ Advice, voluntariness, capacity, language, and accommodation needs addressed

☐ Required contents, warnings, records, and attachments completed

☐ Execution occurred before the correct official or witness in the required manner

☐ Filing, service, review, and copy-delivery steps completed

☐ No private-contract default, remedy, waiver, or electronic-signature term remains

☐ Final consent prepared separately and reviewed by New Hampshire adoption counsel

Retain this checklist with the current official form, authority register,
advice and counseling records, attachments, execution proof, filing receipt,
service proof, and court orders.