Independent Adoption Center

Request Information on Our Open Adoption Program

IAC understands that an unplanned pregnancy raises many issues and many questions. Further, we understand that you know your situation better than anyone else.

Our counselors are prepared to provide you with the support and information that you need as you determine which option is best for you. IAC's trained staff will guide you through all of your options and answer all of your questions.

•All birthmother and birthfather services are free

•You will choose the family for your baby

•IAC's toll free number is 1 800 877-OPEN (6736)

When you're ready to talk with someone to learn more about all of your options including adoption, just give us a call on our toll free number at 1-800-877-OPEN (6736).

IAC's counselors are caring, knowledgeable, and experienced - and want to hear from you. They are prepared to listen and to help you begin developing a plan.

If you would like some information before talking with us just complete the following form and one of our counselors will contact you. To get started, we need you to fill out the boxes that have a red asterisk next to them.

If you want us to send you information by mail, please provide us with your address. All materials will be sent in a confidential envelope.

*Required fields are denoted with a red asterisk.

Name(s) (If you are a couple, please include both names)

*First: *Last: Phone: ( ) -

First: Last: Phone: ( ) -

*E-mail:

Region - *City: *State:

Describe your situation:

Mailing Address (Information will be mailed in a plain, confidential envelope)

Line 1:

Line 2:

City: State: ZIP: -

How did you hear about us?

When you started your adoption information search that led you to our website, where did you first find us? (example: Yellow Pages, Friend, etc.)

How did you hear about us?*

To help us be effective in our outreach to you, it would help us if you could identify exactly the path you used to find us. Please type in the field below the Name of the Search Engine (Google, etc.) or Friend or Counselor, etc. that lead you to us.

Please Name:

If you found us through a Search Engine, please type in the search word or words you used to find us (or you can add any additional text you feel would be helpful to us):

Search Word(s):

Due Date/Months Pregnant:

Comments/Suggestions (Optional)