Considerations for Accessing Adoption-Related Medical Records

Understanding what documents are available and accessible to your adopted child can be a daunting task due to the high variance in U.S. state policies and international policies. Explore the Cradle’s guide to challenges that adoptive families and adopted individuals can face when attempting to gain access to or recover documents related to medical history. 

This article aims to inform adoptive parents about current options, resources and suggestions for understanding access rights for their adopted children and seeking guidance in the process. Much of the information in this article is also applicable to adult adopted individuals whose families did not receive information at placement.  

This article is the second installment in an educational series aiming to improve health literacy and empowerment for adoptive families when assembling a biological family health history for their adopted child(ren).

Why Access to Medical History Records Matters for Adopted Individuals

For adoptive parents, access to official adoption documents can be crucial to assembling your child’s family medical history. Biological family medical history can provide physicians with information that helps assess risk for medical conditions. Family medical history can assist with early intervention and prevention of particular diseases. These conditions can include physical illnesses, as well as mental and cognitive disorders. 

This barrier is particularly relevant for older adopted individuals, those adopted from foster care and those adopted internationally. In the late 1970s and 1980s, the shift from closed adoption to open adoption was beginning in the U.S.; however, it was not until the 1990s and the early 2000s that this practice became more widely adopted. This meant more information began to be shared between birth parents and adoptive parents. However, the timing of when things changed in each state and individual agencies varied. State laws generally changed more slowly, and some agencies and attorneys began changing their practices before the law actually changed. 

In closed adoptions, many have limited to no information about their biological families or face challenges in retaining documents. 

Today, the common practice is for agencies to provide non-identifying medical/social history from the biological mother to the adoptive family at the time of placement. If you did not receive these documents or records, please contact your agency. 

One of the ways adoptive parents can help their children build their family medical history is to seek out adoption documents that include important health information and records. Learn what documents can help construct family medical history, how to approach understanding your and your child’s rights to accessing information and the types of challenges families may encounter in the process.

What Documents Can Help Assemble Family Medical History?

Understanding what “family medical history” entails can help narrow down your search for what available documents may be most relevant. Family medical history can include information such as what prevalent medical conditions, chronic disease, or genetic disorders occur across generations. Common examples include cancer, cardiovascular disease, asthma and single-gene disorders.

Before you start your search for additional documents and records, the best place to start is with what you already have. Many families may forget what information they were given at the time of placement. For this reason, it is extremely important to collect and organize what may have already been given to you by your adoption agency. More details about obtaining and storing documents will be included later in the article.

Some helpful documents that can include this information are non-identifying medical/social histories, which can often be provided by agencies, birth or hospital records, and government-provided adoption records with medical notations. The information provided in these documents may be limited, but information, even in small fragments, can sometimes help providers tailor their approach to preventative care. If you have any knowledge of social history, e.g., adverse childhood experiences, or environmental prenatal exposures, recording and bringing up this information to your provider can be helpful.

However, it should be recognized that the reliability and accuracy of information passed down orally are limited. This information is self-reported by the biological mother and can sometimes include self-diagnoses or speculations about medical conditions. Additionally, biological fathers may not be involved in this process by either choice or circumstance, resulting in only the information the mother knows being shared in the medical and social history.

Important Tips for Researching Your Access to Adoption Records

Rights to access medical information may differ depending on the state or country where the adoption took place. In this section, learn about the key questions and points to look for when researching what may or may not be available to you.

If you adopted your child domestically, the Child Welfare Information Gateway is a U.S. government-run resource database that provides publications, research and learning tools selected and curated by experts to support and educate children, youth, families and communities. Through their state statutes search, you can look up information specific to your state or read their overview on access to adoption records. Another good resource is Adoptees United’s adoption-related legislation map. For intercountry adoption, the U.S. Department of State has information on the retention of adoption records by accredited or approved adoption service providers.

Starting a search for records and information can be overwhelming, especially when many of the important terms you need to know may be unfamiliar. Seeking assistance from post-adoption counselors or your agency’s dedicated post-adoption department can help guide you in the process. Below, you can learn about important vocabulary and questions to be familiar with when researching adoption record access.

• What is nonidentifying information? Nonidentifying information includes the health, behavioral health, developmental, educational and social histories of the child and the child’s biological parents and other relatives. When available, this information is often provided to adoptive parents at the time of placement.
• What is identifying information? Identifying information includes information that can lead to the positive identification of birth parents, the adopted individual or other birth relatives. This can include things such as the name of the person, addresses, employment or other similar identifying information. This information is permitted in nearly all states, but only when the person whose information is included has consented to its release.
• What is a mutual consent registry? Does my state have one? As of 2025, 30 U.S. states and Puerto Rico have established some form of a mutual consent registry. Mutual consent registries are a method many states use for individuals directly involved in adoptions to consent for their identifying information to be disclosed. This can include adult adopted persons, biological parents and biological siblings. Some states use “confidential intermediary systems” where a confidential, court-certified individual can access adoption records for the purpose of searching for and receiving consent for information release from birth family members. Others use an affidavit system through which birth family members can file their written consent. They will also have the option to register their refusal to be contacted or to release identifying information.
• What is the process of requesting the release of information? Restrictions on the release of information can vary greatly by state. Some states require the person seeking nonidentifying information to register with the state adoption registry. The name of the appropriate state agency is not standardized by state, but often is a child welfare bureau or department of public health. Some states have nonidentifying information available through a registry or the court or agency that handled the adoption, while others require a party to petition the court before any information can be released.
• Who can access information? All U.S. States, American Samoa, Guam and Puerto Rico have provisions that allow access to nonidentifying information by an adoptive parent/guardian of a minor child who has been adopted. Typically, an adopted individual can request access to this information independently, but in most cases they must be an adult. The definition of “adult” varies by state, usually age 18 or 21. In some cases, the child of the adopted person can access some records; however, consent from the parent (who is the adopted person) or proof that the parent is deceased is required. Some states allow birth parents access to nonidentifying information about the child. Additionally, some states give such access to adult birth siblings.

Suggestions for Obtaining, Keeping, and Storing Documents

Explore best practices and practical tips for searching for documentation. Keep in mind that adoption practices and laws in different states and countries change over time, so checking the search resources in the previous section can ensure you have the most up-to-date information.

• Remember to start with what you have: Review the documents you may have received with your child’s medical information at the time of adoption. In the busy, transitional process of adoption, it is not uncommon to forget what documentation has already been provided to you. Make sure that before you seek out any additional documents, you are familiar with what has already been provided to you. 
• Ask your adoption agency what documents they may have: Agencies may be able to hold onto records for long periods of time — depending on the state legislature. If you’re seeking documents post-adoption, your agency may still have non-identifying documents relating to your child’s and their biological parent’s health. If you are an adopted adult, agencies can also compile this information upon request. If your agency is closed, contact your state’s children and family services department to inquire if they know where the adoption records from your agency were sent.
• Start with the last known caseworker: Especially in the case of children who have had multiple caseworkers over time due to situations like foster care, it is usually best to start with the last known caseworker. This ensures you are working with someone who has the most up-to-date information. Some adoption agencies may also have a dedicated post-adoption worker or department who can assist you as well. 
• Keep records in their original and translated forms: If your child’s documents were originally written in a foreign language, it’s recommended to keep both the original and translated copies. This is because, outside of potential mistranslations, different languages and cultural influences may describe medical diagnoses in different ways. Additionally, the time period in which the records were written may impact the terminology used in both how it was originally written and how it was translated. It is recommended that you hire a professional translator who specializes in translating medical documents to help you translate original documents if they have not already been provided to you. Working with a translator who may come from the ethnic or cultural background of the country the original documents are from may also ensure you are receiving a culturally accurate translation. 
• Keep documents in a unified, organized and safe place: Make sure you and your immediate family keep any relevant documents in a safe place and are organized in a way that best fits your needs (chronologically, by topic, etc.). As your child gets older, they may want to see the information themselves and will one day become accountable for their own health and medical decisions. 

Being open and honest with your child about their health information and documentation is an essential part of helping your child develop and grow. Some medical and social information can be sensitive and difficult to share with your children. Seeking support from an adoption competent therapist may be helpful in guiding you in how to process this information and share the information with your child in an age-appropriate manner. The Cradle has articles providing guidance on how to have difficult conversations with your child (pre-school age, school age, teens).

Specific Challenges to be Aware of in the Process of Seeking Documents

The process of seeking out adoption documents and other medical information for your adopted child is filled with challenges unique to each child and family’s experience and history. 

• Quality of and access to medical documentation: It is important to recognize that gaining access to medical documentation can already be difficult for adopted individuals. In addition to this, the quality or accuracy of documents cannot be guaranteed. Especially in the case of closed and international adoptions. While any information available is shared, information may be sparse and of uncertain reliability, sometimes due to circumstances surrounding the adoption.
• Legal and logistical hurdles: The process of requesting release of identifying information can be long and difficult, especially given variabilities in state/country law, court responsiveness or requirements for consent from biological relatives. Depending on the state or country that keeps documents,  adopted individuals may not be able to access their records or their records may be limited or no longer exist. Political turmoil can further complicate your family’s ability to travel or access documents in other countries. If your child was previously in the foster care system, moves between homes can result in a higher chance of documents being misplaced or lost. 
• Financial barriers: In some cases, adoptive families or adult adopted individuals themselves must rely on confidential intermediaries or paid search services in order to track down biological relatives and medical information. Because of the challenges posed by international adoption, it is recommended to go to the agency from the country in which you adopted your child in-person. However, this poses a significant barrier in both finances and time to families. 
• Psychological and ethical considerations: Navigating bureaucratic processes and complicated legal systems can be exhausting, especially if you have limited experiences relating to advocacy and the legal system. There is a significant emotional impact and feeling of grief in uncovering or not uncovering parts of medical history for both your child and your family. Seeking support and guidance from both loved ones and trained professionals can be crucial in this process.

Reclaiming Health Through Information Access

Being able to understand and access one’s medical history is a matter of health equity. We encourage adoptive families and adopted individuals to keep learning their state’s law, seek information early and keep their information safe and organized. Oftentimes, the easiest and best way to obtain information is through contact with the birth family throughout the child’s life. This is one of the many benefits for your child’s health (physically, mentally, and emotionally) that open adoption provides. 

It’s important to acknowledge that while seeking out documents can be helpful for building a family medical history, it is not the only way to do so. Families who have limited or no access to information should not feel discouraged or hopeless regarding their adopted child’s health. As discussed in the previous article of the series, assembling one’s family health history is a matter of continuous education alongside your medical provider and adoption professionals in your child’s life. Although this process can be challenging, there are many ways to receive both emotional and practical support and guidance.