Ohio Authorization of Release of Adopted Name (Adopted Person) (HEA 3036)
Official state formAdoptionForm HEA 3036Free downloadLast verified November 10, 2026
Notarized form signed by an adopted person to authorize the release of identifying information about them to a birth parent or birth sibling once the adopted person is age 21 or older. It is mailed to the Ohio Department of Health, Special Registration.
Who can use this form
- The adopted person signs the form.
- The release to the birth parent or birth sibling applies when the adopted person is age 21 or older.
- The adopted person may cancel it by filing a Rescission of Authorization of Release of Adopted Name, and may authorize and rescind as often as they wish.
What to send with it
- The completed form with the adopted person's name after adoption, date of birth and place of birth, typed or printed legibly.
- The adopted person's signature, notarized before the form is sent.
- Two forms of identification, such as a driver's license, identification card, marriage application, social security card, military identification card or employee identification card.
Where to send it
- Mail to
- Ohio Department of Health Attn: Special Registration P.O. Box 15098 Columbus, Ohio 43215
- State fee
- Not provided
- Typical processing
- Not provided
- Form revision
- Rev. 03/2025
- Source
- Official government page