Illinois Birth Parent Preference Form Packet
Official state formAdoptionFree downloadLast verified November 10, 2026
Packet that lets a birth parent choose one of five options (A to E) about contact and the release of their identifying information from the original birth certificate. It is mailed to the Illinois Division of Vital Records, attention IARMIE.
Who can use this form
- Birth parents of an adopted or surrendered person.
- Option E, which withholds identifying information, is not available when the child was born before January 1, 1946.
What to send with it
- The completed packet. It contains a notary block.
- A copy of a valid government-issued photo ID.
- The IARMIE Application form.
- A $15 check or money order payable to Illinois Department of Public Health, or a completed Medical Questionnaire instead of the fee.
Where to send it
- Mail to
- Illinois Department of Public Health Division of Vital Records ATTN: IARMIE 110 West Lawrence Avenue Springfield, Illinois 62704-2610
- State fee
- $15 registration fee. No fee if sent with the IARMIE Application and a completed Medical Information Exchange Questionnaire.
- Typical processing
- Not provided
- Source
- Official government page