White Oak Search and Reunion Questionnaire

 

Your first name: (optional)___________________________

E-mail address or phone # where you can be contacted (required)_________________________

What is your connection to the adoption triad?
adoptee birth mother birth father birth sibling adoptive parent other

What was the adoptee's year of birth? 19____    What is the sex of the adoptee? male female

Who handled the adoption? private attorney (not affiliated with an agency) Catholic Charities or Catholic Social Services The Cradle Lifelink Lutheran Social Services The Baby Fold Dept. of Children and Family Services Children's Home & Aid Society Child Care Association other private adoption agency other public adoption agency do not know who handled the adoption

Adoptee's age at the time of the adoption _____  Birth mother's age at time of adoptee's birth ____

Did the birth mother have other children (after or before the adoptee's birth)?   Yes No

Did the birth mother surrender more than one child for adoption?   Yes No

At what age did the adoptee learn about his/her adoption?
has always known he/she was adopted before the age of 6 between the ages of 6 and 13
between the ages of 13 and 18 over 18

Which of the following information was included on the adoptee's adoption decree?(Check all that apply.) adoptee's birth surname adoptee's given name at birth birth mother's surname birth mother's given name birth mother's middle initial birth father's surname birth father's first name adoptive parents lost or did not receive a copy of the adoption decree adoptive parents refuse to share copy of the adoption decree adoptee does not wish to ask parents for a copy of the adoption decree the adoption decree was reportedly lost, stolen or destroyed

Are you currently searching or did you initiate a search in the past 5 years? Yes No

If you initiated a search, was the person who was the object of the search located? Yes No
Yes, but they were deceased at the time they were located

If you initiated a search and the search was resolved, how long did it take to complete the search?
less than 3 months between 3 and 6 months between 6 months and a year between 1 and 3 years more than 3 years more than a decade

If you initiated a search and the search has not been resolved, how long have you been searching?
less than 3 months between 3 and 6 months between 6 months and a year between 1 and 3 years more than 3 years more than a decade

If the adoptee searched or was reunited, who of the following knew about the adoptee's decision to search and/or reunite?(Check all that apply.) adoptee's partner/spouse adoptee's children
adoptee's adopted siblings adoptee's adoptive parents adoptee's friends adoptee's co-workers adoptive parents were deceased at time of search

How did the adoptive parents feel about the adoptee's decision to search and/or reunite?
they were supportive they were not supportive made positive comments made negative comments voiced no opinion had mixed emotions were not told about the search and/or reunion
adoptive parents were deceased at time of search

Other than the birth mother, who of the following knew about the adoption? (Check all that apply.)
birth mother's parents birth mother's siblings birth mother's friends birth mother's children
birth father   birth father's parents/siblings birth father's partner/spouse birth father's children

If the birth parent searched or was reunited, who of the following knew about the adoptee's decision to search and/or reunite?(Check all that apply.) birth parent's partner/spouse birth parent's children
birth parent's siblings birth parent's parents birth parent's friends birth parent's co-workers

If contact was made between the adoptee and a birth relative, who of the following initiated the contact? the adoptee the birth mother the birth father adoptive parent(s) a birth sibling birth relative other than birth parent or sibling an intermediary from the agency that handled the adoption
certified intermediary private investigator White Oak Foundation other

If contact was made between the adoptee and a birth relative, how was contact initiated? by phone call by letter by e-mail was notified of match by Registry unannounced visit

What was the result of the request for contact? 
no response relative requested more time to reach decision relative declined contact "for now"
relative declined contact indefinitely relative denied they were the person who was the object of the search relative agreed to meet once reunion followed by ongoing relationship

How old was the adoptee at the time of his/her first meeting with a biological relative?
under 21 between 21 and 29 between 30 and 39 over 40 adoptee has never met any of his/her biological relatives

How would you rate your search and reunion experience? (Check all that apply.)
I'm glad I searched/was found I'm sorry I searched/was located I feel like a more complete person since the search I wish I'd searched/been found sooner The search answered questions that had been haunting me for years I exchanged or received important medical information with/from the adoptee/birth relative I had a "great" reunion I was disappointed by my search and reunion experience The search brought to light more questions than it answered I now have a good, ongoing relationship with my birth relative/child I now have limited contacted with the birth relative

Thank you for completing this brief questionnaire and participating in the White Oak Research Project! Please fax completed questionnaires to us at:  312/666-5722 or mail them to The White Oak Foundation, P.O. Box 147142, Chicago, IL 60614-7142