Get Ad 22

Filling out the Ad 22 form, also known as the Health Facility Minor Release Report, is crucial for ensuring the proper release of a minor from a health facility. This guide provides a clear, step-by-step approach for users to complete the form accurately.

Follow the steps to successfully complete the Ad 22 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Section I, enter the child's name, birthdate, and gender as it appears on the Record of Live Birth.
3. For Section II, fill in the name and complete address of the person or agency authorized to remove the child from the health facility. If it is for an independent adoption, also include the names and addresses of the prospective adoptive parents.
4. Complete Section III with the details of the person or agency who will be receiving the child, ensuring it matches what was listed in Section II.
5. Fill out Section IV fully. If the father's name is unknown or withheld, make sure to indicate this.
6. Review all entries for accuracy. Ensure that all signatures are included where required. This includes the parent or guardian's signature and the witness signature.
7. Once completed, save your changes. You can then download, print, or share the form as needed.

Start completing the Ad 22 form online to ensure a smooth release process.