Where can I get the adoption subsidy checklist and forms?
The Subsidized Adoption Program helps people who adopt a child with special needs pay for their ongoing care.
The child’s social worker will work with you to collect information and submit the appropriate forms and documents.
Subsidized Adoption Program packet
- DCF-415 – Checklist for Adoption Subsidy Approval (PDF)
- DCF-416 – Certificate of Special Needs Status (PDF): Submit one copy in the child’s biological name and one in the child’s adopted name. Both are signed by the social/case worker and subsidy manager.
- DCF-418-I Special Needs Adoption Subsidy – Initial Agreement (PDF): Use the child’s adoptive name. This is signed by the adoptive parents’ subsidy manager. If there’s an addendum for services, please submit the proposal outlining additional services signed by all parties.
- DCF-738 – Agreement for Reimbursement of Non-Recurring Adoption Expenses (PDF): Use the child’s adoptive name. This is signed by the adoptive parent(s) and subsidy manager.
- DCF-739 -- Agreement for Reimbursement of Non-Recurring Adoption Expenses (PDF): Use the child’s adoptive name. This is signed and by the adoptive parent(s).
- DCF-337 Genetic Parent(s) Information (PDF): Signed and initialed by DCF social worker and adoptive parent(s).
- DCF-338 Medical Information on Genetic Parent(s) (PDF): Signed by DCF and signed & initialed by the adoptive parent(s)
- Copy of immunization record
- DCF-2248 – Adoption Placement – Child Disclosure (PDF): Signed by pre-adoptive family, DCF, etc.
- VS-51 Copy of Record of Adoption: Signed by the adoptive parent(s).
- Revenue Enhancement Unit (REU) e-mails regarding IV-E status and Social Security benefits, as applicable
- Copy of the child’s birth certificate
- Copy of the child’s Social Security card
- JD-JM-195 Adoption Petition (PDF)
- JD-JM-196 Adoption Data Sheet (PDF)
- JD-JM-197 Adoption Agreement (PDF)
- Copy of the child’s citizenship papers or green card if the child was born outside the United States.