Tennessee Surrender Medical/Social History is a survey used by the state of Tennessee to assess the medical and social needs of individuals who are surrendering for adoption. It is typically filled out by the birth or potential adoptive parents and includes information about the physical and mental health of the child, as well as the medical history of both birth and adoptive families. The survey also covers social and environmental factors that may affect the child’s development. The Tennessee Surrender Medical/Social History is divided into two categories: the Tennessee Adoption Surrender Medical History Form and the Tennessee Adoption Surrender Social History Form. The Medical History Form includes questions about the birth parent’s medical history and that of any siblings, as well as the health of the surrendered child. The Social History Form covers questions about the birth parent’s lifestyle, family history, and social environment.