Submitted by : on Wednesday, March 09, 2016 - 15:58 pm

In Order to be Surrendered the Baby:

  • must be less than 72 hours old
  • must show no signs of abuse or neglect
  • can only be surrendered by a biological parent

Make Sure the Mother Understands the Surrender is Permanent and the Baby will be Placed for Adoption
- Offer her the opportunity to talk with the Adoption Agency

Give her the Safe Delivery FACT Sheet (DHS Pub 867)

Ask her to Sign the Voluntary Release for Adoption of a Surrendered Newborn by Parent (DHS 4820)
- She may decline, but she must be asked!

Ask her to Provide Medical Background Information on the Voluntary Medical Background Form for a Surrendered Newborn (DHS 4819)
- She may decline, but she must be asked!
- If the mother does not write in the requested information herself but provides it orally, document the information and note it was provided to you verbally

Specifically ASK her to Identify the Father of the Baby
- She may decline or may not know who he is, but she must be asked!

Contact a Licensed Adoption Agency for Placement of the Baby

 

Documentation Needed by the Court and Child Placing Agency:

  • Medical Records or Report on the child
  • Birth Verification showing how the child's name will be registered with Vital Records
  • Voluntary Release for Adoption of a Surrendered Newborn by Parent
  • Voluntary Medical Background Form for a Surrendered Newborn
    •  In the space for Emergency Service Provider Observations DOCUMENT:
      • Mother understands she is surrendering her baby for adoption
      • Mother was given the FACT Sheet
      • Mother was asked to sign the Release and complete the Medical Background form
      • Mother was asked to identify father and her response (be sure to note if she was unable or unwilling to do so)

For additional information go to: www.michigan.gov/safedelivery or contact: Adoption Associates at 1-800-677-2367