Post-Adoption Navigator Contact Form

Complete and submit the form below and a Foster Adopt Minnesota Post-Adoption Navigator will follow-up with you within 3-5 business days. If you do not hear from us within this timeframe, please reach out to us by phone (612) 746-5139 or at pan@fosteradoptmn.org.

Select the option that best describes you and follow the instructions below*

I am referring myself: Complete Section A on the contact form below and be sure to fill out all required fields. Do not complete Section B.
I am a professional referring a family: Complete both Sections A & B and check the Authorization To Contact requirement. Failing to do so will prevent Foster Adopt MN from contacting the family.

Section A

Name

Legal Name (if different than above)

Pronoun(s)*

She/her/hers
They/them/theirs
He/him/his
Other

Please specify if you chose "Other"

How did you hear about Post-Adoption Navigator support?

DHS
County Worker
Adoption Worker
HELP Post-Adoption Navigator Outreach (received letter or email)
Foster Adopt Minnesota Website
Foster Adopt Minnesota Employee

Street Address*

Street Address (line 2)

City*

State*

Zip/Postal Code*

County of residence

Native Nation (if applicable)

Does your family live in the United States?*

If your family does not live in the U.S., please indicate your country of residence below.

Phone*

The Post-Adoption Navigator may reach out via text message for check-in, scheduling, support, or resource delivery purposes. Your information will not be shared outside of the HELP Program at Foster Adopt MN. Do you consent to receiving occasional text messages from the HELP Program?

Yes
No

You can opt out at any time.

Email

What is your preferred method of communication?

Phone
Email
Either

Date of adoption finalization (Exact date is preferred; if exact date is unknown, please include month and year)*

Adoption agency and/or county agency*

Tribe (if applicable)

The Post-Adoption Navigator can provide your family with information on permanency support services offered in MN based on your family’s situation and needs. Based on the list below, are there specific resources you are searching for? (Select all that apply)

SUPPORT FOR PARENTS & CAREGIVERS

Therapeutic Services (Please select only if you need assistance with finding an adoption-competent therapist)
Peer Support
Kinship Adoption/Relative Caregiver Resources
Transracial Adoption Resources
LGBTQ+ Resources

SUPPORT FOR CHILDREN & TEENS

Therapeutic Services (Please select only if you need assistance with finding an adoption-competent therapist)
Peer Support
LGBTQ+ Resources

OTHER RESOURCES

ADOPTION-FOCUSED CAMPS, COMMUNITY EVENTS & FAMILY ACTIVITIES
TRAINING OPPORTUNITIES
GENERAL ADOPTION-FOCUSED RESOURCES (BLOGS, BOOKS, ARTICLES, ONLINE RESOURCES, ETC)
FETAL ALCOHOL SPECTRUM DISORDER (FASD)
SCHOOL SUPPORTS

Please list any other information, resources or support you are looking for, below:

Which of the following best describes your adoption experience(s) – (this will help us provide resources that are most relevant to your family):

Adoption through MN Foster Care (specify county and adoption agency if applicable)
Native American Adoption (specify Native Nation if applicable)
Adopted through another state

Please specify which Native Nation or state

MN Foster Care County & Adoption Agency

Specify agency used for private adoption.

Specify agency used for international adoption.

I’m a(n):

Adoptive parent (post-finalization)
Pre-adoptive parent (pre-finalization)
Kinship adoptive parent or Relative caregiver. Please select this option if you were related (grandparent, aunt/uncle, cousin, etc.) to the child or if you were known to the child (teacher, coach, community member, member of child's Native Nation, etc.) prior to starting the adoption process.
Other:

Please specify your connection to your child prior to their adoption.

Other:

Anticipated finalization date (if applicable):*

The total # of foster and/or adopted youth currently in our household:

Age of each child in your home:

Would you like to be added to the following email lists to receive monthly updates?

Foster Adopt MN Trainings (upcoming workshops & webinars)
Foster Adopt MN Monthly Insider Newsletter (upcoming events, services and resource highlights)
No, thanks!

All families are automatically signed up for the monthly Post-Adoption Navigator resource newsletter.

Post-Adoption Navigator Program Overview and Confidentiality Statement

Please review and electronically sign this form that includes an overview of the Post-Adoption Navigator Program and our Confidentiality Statement.

Post-Adoption Navigator Program services include:

A direct link to an adoption-competent professional to help respond to your family’s adoption-related questions
Periodic check-ins throughout your family’s first year following finalization
Connections and referrals to the post-adoption supportive resources available to you
Topic-specific resource guides to address your family’s adoption-related needs
A monthly newsletter featuring helpful resources, training opportunities, and family activities
Free or reduced registration for live webinars offered through Foster Adopt Minnesota

Confidentiality

The Post-Adoption Navigator will keep the information you share with them confidential unless:

you provide expressed written consent to share your information (e.g. if you consent to the Post-Adoption Navigator sharing your information for the purpose of connecting your family with a service provider)
disclosure of the information is required by statute or court order (e.g. reporting threat of harm to self or others; known or suspected abuse or neglect of a vulnerable adult or child within the last 3 years)
disclosure is required by the Permanency Support Services contract between Foster Adopt Minnesota and the Minnesota Department of Human Services

By signing this agreement, you agree that:

You understand the information included above;
You consent to participating in phone, email, and other communication with the Post-Adoption Navigator Program; and
You are at least 18 years old and have the capacity to consent to this agreement.

Post-Adoption Navigator Program Overview and Confidentiality Statement Acknowledgement

Consent*

By checking this box and including your signature below, you are acknowledging that you have read and understand the Post-Adoption Navigator Overview and Confidentiality Statement.

Name*

Electronic Signature (Type in First and Last Name)

Section B (For Professionals Referring a Family)

Name

First Last

Organization Name

Phone

Email

Authorization to Contact Family:

By checking this box you acknowledge that you have received authorization directly from the family to share their contact information with Foster Adopt MN in order for the Post-Adoption Navigator to contact the family directly. Failing to receive authorization will prevent Foster Adopt MN from contacting the family.

I have authorization from the family

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Comments

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Overview