Birth Mother Application

Welcome to the beginning of your journey. 

Please be sure to complete all of the following


Step 1

Your First Step is to Complete the Primary Application. 

NEXT Complete the Release of Information

the Financial Worksheet indicates what your' financial needs are.

GREAT! Now you have completed Step 1 LETS move on to STEP 2!

Step 2

We need you to upload your Driver's License, State I.D. or Passport and your Proof of Pregnancy by your last Ultrasound.


In most cases, you will not need to reveal who the biological father is if you don't want to. The Declaration Concerning the Biological Father needs to be filled out truthfully and completely as to insure we do everything the law requires.

SUPER! Now you have completed Step 2 you are almost done!   NOW move on to STEP 3!

Step 3

There are 4 PAGES here for you to sign. This protects your Rights when working with our agency. Page 3 is for the biological father if he is involved.

The Social Health History is the information the adoptive family will have about the child's overall health.


Thank You

After we get your ALL 8 forms, we'll mail you a package that will contain a reloadable MasterCard which is to be used for your financial needs and/or travel to Utah.





    • Complete each step of the application process. Paperwork that is missing will delay the process.
    • Contact us with any questions or concerns (877-437-3424) We are available 24/7


More Information About The Application Process

This online application is just the beginning. Following are the steps you can expect to take in your adoption journey.

Completing his application. Complete the online forms listed in the checklist. Every time you complete a form, you'll get an email with a PDF version of your submission (unless you choose to opt out of receiving emails for privacy reasons). Please review the PDFs to ensure you've answered everything correctly and provided everything we need.

Getting your MasterCard. After we get your application materials, we'll mail you a package that will contain a reloadable MasterCard.

Planning where you will deliver. You will have the option of staying where you are or moving to a comfortable apartment in Utah, that we will provide, where you will be able to stay until your delivery.

Choosing an adoptive family. Based on what you want in an adoptive family, we will select profiles of families and you will be able to choose a family from these profiles. You can have a phone call, Skype or FaceTime with the family and/or meet them.

Delivering the baby and placing with the adoptive family. Depending on where you deliver, we and/or the adoptive family can be at the hospital with you or we can come later. You can spend as much or as little time as you want with the baby while in the hospital.

Your transition plan. We can help with finances for the period following your delivery to help you transition from pregnancy to the next phase of your life.

Post-Placement support. We will be available to help facilitate communication between you and your adoptive family and provide support and counseling for as long as you feel you may need it.

Facing an unexpected pregnancy is a life-changing experience; one we don’t want you to go through alone.

Call us at 877-437-3424 anytime day or night.

You can also text us any time ANYTIME at 801-871-5773.

Seriously. Anytime. For any reason.

That's what we're here for.

Contact Information:
801-563-1000 office
877-437-3424 toll free
801-871-5773 text

Heart to Heart Staff 2018

Call Us Anytime

Local Phone: 801-563-1000
Toll Free: 877-437-3424

Email or Text Anytime

Text: 801-871-5773