Adoptive Family Consultation

Please complete the following consultation form to schedule a free, no obligation, OFFICE VISIT (sorry, no phone consultations) with our Founder & Executive Director Steffany Aye. These free office consultations are offered to families residing in Kansas or Missouri only (as these are the states we are licensed within).

Steffany will provide you with an in-depth face-to-face consultation that will cover the six different types of adoption. Our consultation will help streamline everything you have been reading, researching, learning from the internet and from others. It is our hope that you will find the office consultation beneficial and will provide you with the information needed to choose the avenue(s) of adoption that are right for your family.

Our consultation visits occur in our office with your spouse or significant other present, if single we encourage you to bring a support person with you. This office visit usually lasts less than an hour, depending on how many questions you have. There is no need to bring anything with you to this meeting, and we look forward to meeting you soon!

NOTE: If you have previously submitted any forms on our website, like the Information Request or Consultation Form, click Yes, Login button below this will save you time and prevent double entry of information. If you can't remember your password, that's OK, you can reset it.

We may be able to save you time by pre-filling the form with the information that you have previously entered.

Have you previously submitted your information to us?

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Prospective Adoptive FATHER (If same sex family, either adopting parent can be Ap 1 or 2)

Ap 1 LAST Name*

Ap 1 FIRST Name*

Ap 1 Preferred FIRST Name

If different from Legal First Name

Ap 1 DOB*

Ap 1 Gender*

Ap 1 Citizenship

Show All Countries

Ap 1 Occupation*

Ap 1 Cell Phone

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Enter Int'l Number

Ap 1 Email

Ap 1 Preferred Contact Method

Prospective Adoptive MOTHER (If same sex family, either adopting parent can be Ap 1 or 2)

Ap 2 LAST Name*

Ap 2 FIRST Name*

Ap 2 Preferred FIRST Name

If Different from Legal First Name

Ap 2 DOB*

Ap 2 Gender*

Ap 2 Citizenship

Show All Countries

Ap 2 Occupation*

Ap 2 Cell Phone

()-ext

Enter Int'l Number

Ap 2 Email

Ap 2 Preferred Contact Method

Marriage Information- If applicable
Marriage Date

Family Address

Street Address*

Street Address Line 2

City*

State/Region*

Enter Region

Zip Code*

Family Shipping Address

If different from the Residence Address.

Shipping Street Address

Shipping Street Address Line 2

Shipping City

Shipping State/Region

Enter Region

Shipping Zip Code

Contact
Family's Primary E-Mail Address*
Opt Out of Agency E-Mailings
Used only on a limited basis for important information
Opt Out of Agency Mailings
Mailings from us are extremely rare

How did you learn about our agency?
How did you hear about us?*
Referral Source Details

Categories Interested In
Please select the categories which you are interested in at this time	Domestic Adoption International Adoption Embryo Adoption Foster Care Adoption Trans-Racial Adoption Home Study Services Other
If you selected Other, Please Specify

What brings you to our office?
Briefly explain what brings you to our office for a consultation and what you hope to learn during our time together:*

If you have any Special Communication needs, then please explain:

Consultation Time Preference

Check all that apply. We will contact you via e-mail to set up an office appointment time.

Day Time Appointment (T, W, Th 11 am - 3 pm)

Evening Appointment (Monday @ 5, 6, 7 pm)

Phone number for scheduling, if we are unable to reach you via e-mail

()-ext

Enter Int'l Number

We will most likely e-mail you for an appointment time

Notes:

Please indicate in Notes if you already have an appointment scheduled. Thanks!

Additional Information
Do you have a current adoption home study started or completed by another agency?*	YesNo
If yes, please explain

Password
Please enter a password to use at a later time to access other forms on our website. Please write down and keep this password in a safe place.
Family Login Password	Password Already Set Change Password
Confirm Password
Password must be at least 8 characters with at least one uppercase letter, one lowercase letter, and one number.

Office Use Only
Consultation Visit Date
Note:

Children: Gender and Age

How many children do you currently have?

	Birth Date	Gender

Thank you! We will contact you shortly to schedule your consultation visit.

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Adoption & Beyond | 16236 Metcalf Avenue | Overland Park, KS 66085 | 913-381-6919