BF Application - All For Children - Alliance for Children

Pregnant? Call 412-706-4274
Adopting? Call 781-444-7148
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BIRTH FATHER INFORMATION

Please fill out the form below. Everything you share with us is private and confidential. Everything You Share with Us is Private and Confidential.

Name
First Last
BIRTH FATHER - GENERAL INFORMATION
Do you know the birth father?
If No, please explain
Birth Father's Name
First Last
Birth Father's Date of Birth*
MM slash DD slash YYYY
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone Number
Cell Phone Number
Does the birth father know you are pregnant?
- Yes
- No
Does Birth Father know you are making an adoption plan?
- Yes
- No
If yes, how does he feel about the pregnancy?
If yes, how does he feel about making an adoption plan for this child?
If no and does not know about the adoption plan, please describe the situation.
Please describe your relationship (past and or present), if any, with the birth father.
BIRTH FATHER DESCRIPTIVE INFORMATION
Marital Status
Religion
Ethnicity (please check all that apply)
- Hispanic
- African American
- Caucasian
- Asian/South Asian
- American Indian
- Other
What is your national heritage (ex: Irish, Haitian, Puerto Rican, etc.)
Height
Approximate Weight (before pregnancy)
Eye Color
- Blue
- Brown
- Green
- Hazel
- Other
Skin Color
- Dark
- Fair
- Olive
- Tan
- Other
Hair Color
Hair Texture
CHILDREN INFORMATION
Has the birth father ever placed a child for adoption before?
- Yes
- No
If Yes, please describe in detail
Does the birth father have any other children?
- Yes
- No
If Yes, are they living with you?
- Yes
- No
If No, please describe the circumstances:
- Child's Name
- Child's Gender
- Child's Birthday
Comments or Questions

Save and Continue Later

Δ

BIRTH FATHER INFORMATION (M)

Please fill out the form below. Everything you share with us is private and confidential.

Name
First Last
BIRTH FATHER - GENERAL INFORMATION
Do you know the birth father?
If No, please explain
Birth Father's Name
First Last
Birth Father's Date of Birth*
MM slash DD slash YYYY
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone Number
Cell Phone Number
Does the birth father know you are pregnant?
- Yes
- No
Does Birth Father know you are making an adoption plan?
- Yes
- No
If yes, how does he feel about the pregnancy?
If yes, how does he feel about making an adoption plan for this child?
If no and does not know about the adoption plan, please describe the situation.
Please describe your relationship (past and or present), if any, with the birth father.
BIRTH FATHER DESCRIPTIVE INFORMATION
Marital Status
Religion
Ethnicity (please check all that apply)
- Hispanic
- African American
- Caucasian
- Asian/South Asian
- American Indian
- Other
What is your national heritage (ex: Irish, Haitian, Puerto Rican, etc.)
Height
Weight
Eye Color
- Blue
- Brown
- Green
- Hazel
- Other
Skin Color
- Dark
- Fair
- Olive
- Tan
- Other
Hair Color
Hair Texture
CHILDREN INFORMATION
Has the birth father ever placed a child for adoption before?
- Yes
- No
If Yes, please describe in detail
Does the birth father have any other children?
- Yes
- No
If Yes, are they living with you?
- Yes
- No
If No, please describe the circumstances:
Child's Name
Child's Gender
Child's Age
Child's Name
Child's Gender
Child's Age
Child's Name
Child's Gender
Child's Age
Comments or Questions

Save and Continue Later

Δ

ADDITIONAL BIRTH PARENT FORMS

CHOOSING AN ADOPTIVE FAMILY

BIRTH MOTHER MEDICAL HISTORY

HOSPITAL PREFERENCES

SOCIAL PROFILE INFORMATION

BIRTH PARENT LIVING EXPENSES

BIRTH MOTHER APPLICATION

OUR LOCATIONS

Locations

Massachusetts Office
292 Reservoir St.
Needham, MA 02494
PH: (781) 444-7148

New Jersey Office
500 Paterson Plank Road
Union City, NJ 07087
PH: (201) 474-5603

Texas Office
4316 Canyon Dr.
Amarillo, TX 79109
PH: (254) 877-9724

Southern Florida Office
8950 SW 74 Court
Suite 2201-A108
Miami, FL 33156
PH: (239) 488-2550

New York Office
307 West 38th St.
16th Floor
New York, NY 10018
PH: (212) 202-2812

Pennsylvania Office
1650 Market St.
Suite 3600
Philadelphia, PA 19103
PH: (267) 518-3267

Rhode Island Office
10 Dorrance Street Suite 700 - #3300 Providence, RI 02903 (401) 240-2159

Connecticut Office
2433 Main St.
Office 2A
Rocky Hill, CT 06067
PH: (203) 539-0147

Arkansas Office
2 Live Oaks Ct.
Little Rock 72223
PH: (479)244-3181

The Alliance for Children is licensed in Massachusetts, Rhode Island, Connecticut, New York, New Jersey, Pennsylvania, Florida, Arkansas and Texas!

Additional information about applications, placements, disruptions and waiting children for the past three years is available upon request.

We provide home study and post-placement services to families living in states in which we are licensed. However, we can provide birth parent and adoption placement services to clients in all 50 states.

. Non-Discrimination: Admissions, the provisions of services, and referrals of clients shall be made without regard to race, color, religious creed, disability, ancestry, marital status, national origin (including limited English proficiency), age, gender, gender identity, gender expression, sexual orientation, or any other characteristic that is legally protected. Programs and services shall be made accessible to eligible persons with disabilities through the most practical and economically feasible methods available.