Arizona Birth Parent Medical History Form
Official state formAdoptionFree downloadLast verified November 10, 2026
Lets a birth parent file family medical history that is disclosed only to the adoptee, along with the original birth certificate. It is mailed to the Bureau of Vital Records in Phoenix.
Who can use this form
- The birth mother or birth father of an adopted child.
- The form says the information is confidential and is not disclosed to anyone other than the adoptee.
What to send with it
- The completed form. Write "unknown" in any field you do not know or do not want to share.
- To update the information later, send a new form to ADHS, P.O. Box 6018, Phoenix, AZ 85005.
Where to send it
- Mail to
- The Bureau of Vital Records P.O. Box 6018 Phoenix, Arizona 85005
- State fee
- Not provided
- Typical processing
- Not provided
- Form revision
- Revised 09/24/2025
- Source
- Official government page