Indiana adoption medical history report 2026

1. Click ‘Get Form’ to open the Indiana Adoption Medical History Report in the editor.
2. Begin with Section I - Affirmation. Type or print your name, date of birth, and mailing address in black ink. Ensure you provide a written signature affirming the accuracy of the medical history.
3. Proceed to Section II - Medical History. Here, you will find checkboxes for various medical conditions. Mark an 'X' in the appropriate boxes for the birth mother, father, and adopted person as applicable.
4. For each condition listed from Items 1 through 6, provide additional details in the designated section if necessary. This may include information about congenital conditions or significant family medical history.
5. If more space is needed for details, use plain white paper labeled with 'Item/Details' and ensure it includes page numbers. Remember to keep all information confidential and avoid identifying details.

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