C. Right to Adoption Counseling
You have the right to receive adoption counseling and guidance. If you want adoption counseling
or guidance, you should not complete this consent form until after you have gotten adoption
counseling or guidance.
D. Effect of Signing the Consent Form
IF YOU SIGN THE CONSENT FORM, YOU WILL NOT BE GIVING UP ANY RIGHTS
OR RESPONSIBILITIES RELATING TO THE CHILD.
E. Right to Revoke Consent
If you sign the consent form and then change your mind and no longer want to consent, you have
the right to revoke (cancel) the consent within 30 days after the date that you sign the consent
form. The only way that you can revoke this consent is by giving a signed written revocation
statement with the name, sex, and date of birth of the child (if you know it) to:
Adoption Clerk, Circuit Court for at (Address).
The revocation must be sent to the court, not to the lawyers or the people adopting the child. You
may deliver your written revocation of consent in person or by mail. If it is not received by the
Adoption Clerk's office within 30 days after the date you signed the consent form, it will be too
late, and you will not be able to withdraw the consent or stop the adoption from being granted.
If you sign this consent form, and then revoke your consent, and then decide to consent to the
adoption again, you will not be able to revoke your second consent if you give your second
consent in court within one year of your revocation of this consent.
G. Further Notice of Adoption Proceedings
A petition for adoption has been or will be filed in the Circuit Court for .
If you sign the consent form, your written consent will also be filed in the court. You have the
right to be notified when the petition is filed, when any hearings are held before the adoption is
granted, and if and when the adoption is granted. Any notices will be sent to the address given by
you on the consent form, unless you write to the Adoption Clerk at
(court's address) and give the clerk your new address. You may
waive (give up) your right to notice if you wish to do so. Even if you give up your right to notice,
someone from the court may contact you if further information is needed.
Under Maryland law, you are not allowed to charge or receive money or compensation of any
kind for the placement for adoption of your child or for your agreement to the adoptive parent
having custody of your child, except for (1) reasonable and customary charges or fees for
adoption counseling, hospital, legal, or medical services, (2) reasonable expenses for
transportation for medical care associated with the pregnancy or birth of the child, (3) reasonable
expenses for food, clothing, and shelter for a birth mother if, on written advice of a physician, the
birth mother is unable to work or otherwise support herself because of medical reasons associated
with the pregnancy or birth of the child, and (4) reasonable expenses associated with any required
court appearance relating to the adoption, including transportation, food, and lodging expenses.
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