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Iowa Biological Parent Contact Preference Form

Official state formAdoptionFree downloadLast verified November 10, 2026

Lets a biological parent named on an original Iowa birth certificate say whether they want contact, contact through an intermediary, no contact, or their identifying information redacted. It is filed with the state registrar.

Who can use this form

  • The biological mother or biological father listed on the original birth certificate of an adoptee born in Iowa
  • The form is destroyed if the person filing it is not listed on the birth certificate

What to send with it

  • The form with one contact preference checked, signed in front of a notary public
  • A clear photocopy of your current government-issued photo ID

Where to send it

Mail to
Iowa Department of Public Health Bureau of Health Statistics Lucas State Office Building, 1st Floor 321 E. 12th Street Des Moines, Iowa 50319-0075
State fee
Not provided
Typical processing
Not provided
Form revision
Created 05/01/2021
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Iowa Biological Parent Contact Preference Form | Iowa Form