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1. Form Title and Reference Number: Official title of the form and any reference numbers required by the Adoption Authority of Ireland
2. Personal Details of the Child: Full name, date of birth, place of birth, and current address of the child to be adopted
3. Birth Parent(s) Information: Full names, addresses, and contact details of the birth parent(s) giving consent
4. Legal Status Declaration: Declaration of the legal status of the person(s) giving consent and their relationship to the child
5. Counselling Confirmation: Confirmation that appropriate counselling has been received regarding the effects and implications of adoption
6. Consent Declaration: Formal declaration of free and informed consent to the adoption, including acknowledgment of the permanent nature of adoption
7. Understanding of Legal Effects: Explicit confirmation that the consenting party understands the legal implications of adoption
8. Withdrawal Period Notice: Information about the right to withdraw consent and the applicable timeframe
9. Witness Details: Information and signature spaces for required witnesses (typically a solicitor or commissioner for oaths)
10. Signatures and Dates: Formal signature section with date and time of signing
1. Interpreter Declaration: Required when the person giving consent needs language interpretation services
2. Medical Information Release: Optional authorization to release relevant medical information about the child
3. Cultural Heritage Preservation: Optional section for cases involving children from distinct cultural backgrounds
4. Contact Preferences: Optional section for specifying future contact arrangements or preferences
5. Step-Parent Adoption Specific Consent: Required only in cases of step-parent adoption
6. International Adoption Requirements: Required for intercountry adoptions, including specific requirements under the Hague Convention
7. Guardian ad Litem Statement: Required when a guardian ad litem has been appointed for the child
1. Schedule A - Information Sheet: Detailed information about the legal effects of adoption and rights of all parties
2. Schedule B - Counselling Certificate: Certificate from the approved counsellor confirming provision of adoption counselling
3. Schedule C - Identity Documents: Copies of identification documents of the consenting party/parties
4. Schedule D - Birth Certificate: Copy of the child's original birth certificate
5. Appendix 1 - Legal Rights Summary: Summary of legal rights and obligations related to adoption consent
6. Appendix 2 - Support Services: List of available support services and contact information
Legal Services
Social Services
Healthcare
Public Administration
Child Protection Services
Family Services
Non-Profit Organizations
Government Services
Educational Services
Legal
Social Services
Administrative Support
Child Protection
Family Services
Compliance
Document Processing
Client Relations
Public Affairs
Healthcare Support
Family Law Solicitor
Social Worker
Adoption Services Coordinator
Legal Administrative Assistant
Family Court Judge
Child Protection Officer
Healthcare Administrator
Legal Secretary
Public Notary
Commissioner for Oaths
Guardian ad Litem
Family Services Director
Adoption Agency Manager
Legal Compliance Officer
Child Welfare Officer
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