South Carolina Biological Parent's Request to Add Consent, Contact Preference or Medical History Forms (4022-ENG-DPH)
Official state formAdoptionForm 4022-ENG-DPHFree downloadLast verified November 10, 2026
A biological parent uses this application to ask the Vital Records Section to place a consent and contact preference form, a medical history form, or both in the sealed file with the adoptee's original birth certificate.
Who can use this form
- A biological parent consenting to the release of the original birth certificate or other sealed adoption file documents to the adoptee
- The biological parent completes and signs the applicant section
What to send with it
- This application, completed and signed
- The enclosed consent, contact preference or medical history form
- A money order or cashier's check payable to SC DPH
- A legible photocopy of a valid government-issued picture ID
Where to send it
- Mail to
- SC DPH - Vital Records P.O. Box 2046 West Columbia, SC 29171
- State fee
- $12 search fee plus $15 special filing fee, non-refundable. The office's website gives the total as $27.
- Typical processing
- About 4 weeks from the date of receipt for mail requests.
- Form revision
- 07/2024
- Source
- Official government page