Robert H. Klima, P.C.
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Building Families Through Adoption for Over 30 Years

Social and Medical History

It is important for the birth mother to complete a Social and Medical History form. If it is possible, the birth father should complete one as well.  These forms are designed to give you as much information as possible about the genetic and medical history of the birth parents.  They are also designed to enable the birth parents to disclose any substances which they ingested that may affect the child.  These substances include alcohol, tobacco and illegal drugs.  The doctor may want to review these forms prior to delivery.  You will want to keep them on file, as you may need this information later in your child's life to enable his or her pediatrican to give proper treatment.

Be aware of the question contained in these forms concerning any possible Native American heritage.  There is a federal law called the Indian Child Welfare Act which states that if the child has a certain amount of Native American heritage, the permission of the tribe is necessary before the child may be placed for adoption.  You need to know as soon as possible whether or not this will be an issue.

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Robert H. KLIMA, PC.

9300 Grant Avenue
Suite 101
Manassas, VA 20110

Phone: 703-361-5051
Fax: 703-330-2090
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