Adoption Consent Form - Preparation Worksheet - Tennessee

ADOPTION CONSENT FORM

Tennessee — Non-Operative Preparation Checklist

DO NOT SIGN OR FILE THIS CHECKLIST. It does not surrender parental rights, consent to adoption, start or waive a revocation period, authorize placement, or satisfy any court, agency, witness, notary, officiant, counseling, or filing requirement.

1. Matter and Court Information

2. Required Route Classification

Select only after Tennessee counsel reviews the facts:

☐ Judicial surrender before the authorized judge or officiant
☐ Agency or Department of Children's Services surrender
☐ Consent within an adoption petition or proceeding
☐ Putative-father or parentage-specific consent, notice, or waiver route
☐ Minor-parent or represented-parent procedure
☐ Guardian or legal-custodian consent route
☐ Child consent or interview route
☐ Interstate Compact, tribal, military, incarcerated-parent, or out-of-state execution issue
☐ Involuntary termination rather than voluntary consent
☐ Other: [________________________________]

Reason this route applies: [________________________________]

3. Current Official Source Packet

4. Timing and Withdrawal Analysis

Complete from the current official statute and form; do not use a generic number of hours or days.

5. Execution Ceremony and Capacity

6. Persons Whose Rights or Consent Must Be Addressed

7. Required Information and Attachments

☐ Certified birth record or accepted substitute
☐ Parentage, marriage, divorce, custody, guardianship, dependency, or support orders
☐ Putative-father registry or notice materials
☐ Social, medical, and genetic history materials required for the route
☐ Agency licenses, placement documents, and interstate approvals
☐ Counsel certifications or waivers
☐ Interpreter or accommodation certification
☐ Current official surrender, consent, and revocation forms
☐ Filing cover sheet, fee, and service documents
☐ Other: [________________________________]

8. Final Attorney and Official-Form Handoff

Before any operative document is signed:

☐ Tennessee counsel confirmed the route, court, venue, and persons whose rights must be addressed.
☐ Every current official source listed in Section 3 was opened and read in full.
☐ The exact timing and revocation rules were entered from the current source, not from this checklist.
☐ The signer received the required explanation, counsel, counseling, interpreter, and accommodation process.
☐ The current official form—not this checklist—was completed without deleting mandatory text.
☐ The execution ceremony, witnesses, acknowledgment, officiant, filing, and delivery steps are scheduled.
☐ Copies, confidentiality, records, and post-execution notices are addressed under the current procedure.

Attorney / authorized professional responsible for operative form: [________________________________]
Official form and revision selected: [________________________________]
Planned execution date and official: [________________________________]

This checklist intentionally contains no parent signature or consent language. Use only the current official Tennessee form selected by qualified Tennessee adoption counsel.