HOSPITAL STAY PREFERENCES - All For Children - Alliance for Children

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Adopting? Call 781-444-7148
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HOSPITAL STAY PREFERENCE

The purpose of this form is to explore your wishes and act as a guideline. Please complete the information below to give us an idea of what you are thinking at this time.

Name
First Last
During my labor, I would prefer that the following people be in the room with me:
- My Family/Friends
- Adopting Mother(s)
- Adopting Father(s)
- Alliance for Children Counselor
At the time of my delivery, I would prefer that the following people be in the room with me:
- My Family/Friends
- Adopting Mother(s)
- Adopting Father(s)
- Alliance for Children Counselor
When the baby is born, I would like to:
- Hold the baby first by myself
- Request that the doctor give the baby to the adopting parent(s) to hold immediately
- Prefer not to see the baby at all
During the postpartum, I prefer that the adopting parent(s):
- Stay in my room with me and the baby
- Stay in another room or in the nursery with the baby
- Spend time in my room with the baby and some time in the nursery
I would like to be off the nursery floor following delivery prior to discharge:
- Yes
- No
I would like to spend time alone with the baby prior to discharge:
- Yes
- No
I understand that I will meet with the hospital Social Worker to complete the hospital discharge paperwork. I also understand that he/she will confirm that I am comfortable with my adoption plan:
- Yes
- No
I have been advised that I will complete the birth certificate form:
- Yes
- No
I prefer to:
- Have an outfit and dress my baby upon discharge
- Have the adopting parent(s) bring an outfit and dress the baby upon discharge
At the time of discharge, I prefer to:
- Leave the hospital before the baby and adopting parent(s)
- Leave the hospital after the baby and adopting parent(s)
- Leave the hospital together with the baby and adopting parent(s)

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ADDITIONAL BIRTH PARENT FORMS

CHOOSING AN ADOPTIVE FAMILY

BIRTH MOTHER MEDICAL HISTORY

SOCIAL PROFILE INFORMATION

BIRTH FATHER 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.