Washington Adoptee Request for the Location and Case Number of Adoption (DOH 422-101)
Official state formAdoptionForm DOH 422-101Free downloadLast verified November 10, 2026
An adult adoptee born in Washington State completes this form to ask for the county where the adoption was finalized and the case number. It is mailed to the Center for Health Statistics at the Washington State Department of Health.
Who can use this form
- An adopted person who was born in Washington State and is 18 or older
- The adoptee completes and signs the form under penalty of perjury
What to send with it
- The completed and signed form
- A copy of your current photo identification (driver's license or state ID card)
- A $15 check or money order payable to Department of Health
Where to send it
- Mail to
- Center for Health Statistics PO Box 9709 Olympia, Washington 98507-9709
- State fee
- $15
- Typical processing
- Two months, per the office's adoption pages
- Form revision
- September 2014
- Source
- Official government page