Fill Form and submit to generate PDF

CURRENT DETAILS

Birth Mother - (Information at time of birth of child):

-

BIRTH FATHER -(Information at the time of YOUR birth)

Circumstances

Your Documents

Searching

IMPORTANT INFO:

Please provide details of a close contact NOT living at your address so that we can contact in the event you change your address and do not notify us:

Agreement

I authorise Jigsaw Search & Contact to undertake search, contact and mediation services on my behalf. I authorise Jigsaw to receive on my behalf copies of all relevant certificates and/or information pertaining to myself and my relinquishing family.

I consent to Isabel Andrews (Licensed Mediator) sharing and receiving information with or from the relevant Adoption Agency and or Government Department if deemed appropriate. Contact and Mediation involves sharing information with the found party. I take responsibility to specify what, if any, information is to be kept confidential from the found party (this will be discussed in the interview with the mediator).

I agree at all times to abide by the Constitution of Jigsaw Search & Contact Inc., and to act strictly within the law of the relevant Adoption Act.

In the event of my birth mother/father/family NOT wishing to have any contact with me, I assume full responsibility for any actions taken by me after Jigsaw has advised me that No Contact has been requested by my birth mother/father/ family.