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Parents for Ethical Adoption Reform
Ethics ~ Transparency ~ Support
What All Adoptions Deserve.

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PEAR Health, Education and Support Resources

International Adoption Doctor, Clinic, and Provider Directory:

Note: Parents for Ethical Adoption Reform (PEAR) does not officially endorse any listing in this directory. The contents are provided for informational purposes only as a community service. PEAR has no means of certifying the competence or quality of practice of any practitioner. PEAR makes no representations, warranties, guarantees or promises on behalf of or for those listed, and does not assume liability or responsibility for any service or product provided.
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PEAR State Directories of Adoption Resources

State Specific Guides to Health, Education, Bureaucracy and Support for Adoptive Parents:

How to Use:
Each state directory is arranged into four sections: Health, Education, Bureaucracy, and Support alphabetically by city.

Health contains Early Intervention information and licensed practitioner listings. Each listing has a designation for specialty or service. See the index at the beginning of each document for definitions. Residential Treatment Centers are included here.

Education contains tutoring, remediation, specialized schools & interventions by non-licensed practitioners.

Bureaucracy contains information about (details vary by state):
  • Apostilles & Authentications
  • Better Business Bureau
  • Criminal background checks
  • Recognition of foreign birth, delayed certificate of birth, and/or readoption
  • Filing complaints
  • Hague Convention information (due diligence and complaints)
  • Licensed agency list or checks
  • License checks for health professionals
  • Medicaid waiver
  • Notary
  • State statutes on adoption
  • Social Security offices/how to obtain card
  • State adoption subsidy
  • USCIS
  • Vital records (birth, marriage & divorce cert.)

Support contains state-based support groups, web-support, and organizations. Respite care is also included here.

Note: Parents for Ethical Adoption Reform (PEAR) does not officially endorse any listing in these directories. The contents are provided for informational purposes only as a community service. PEAR has no means of certifying the competence or quality of practice of any practitioner. PEAR makes no representations, warranties, guarantees or promises on behalf of or for those listed, and does not assume liability or responsibility for any service or product provided.
Please consider sharing additional resources through our Provider Surveys below. Updates and additional information can also be sent to:


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Choosing an Adoption Agency

PEAR Guide to Researching US Adoption Agencies

There is no one place to go to research an adoption agency. Information must be obtained and interpreted  from several sources (see special notes at the end). At minimum, we suggest that prospective adoptive parents do the following:
  1. Refer to PEAR Prospective Parents Bill of Rights as you assess the agency and/or country program.

  2. Check the Better Business Bureau* local to the adoption agency and state licensing authorities for complaints. PEAR state directories have this information in the Bureaucracy section. See the State directories tab on this page. If a state has not been released yet, the information can be found by internet search.

  3. Contact the Council on Accreditation (COA)** to see if any complaints have been lodged against the agency. Contact information: jschmidt@coanet.org or 866-262-8088 ext. 203.

  4. If adopting internationally, check Hague status. A list of Convention countries can be found at the US Department of State website .

    If the foreign country you are adopting from is part of the convention, you need to use a Hague-accredited agency as the primary provider of your adoption services. See the list of accredited agencies.

    Some agencies have been denied Hague accreditation. See the list of denied agencies.

    Even if you are not adopting from a country that is party to Hague, it is important to note that the denied agencies could not meet Hague requirements. Proceed with caution when considering an agency that has been denied this accreditation.

    Some agencies work with supervised providers. These are agencies that have not applied for Hague accreditation or have not met Hague requirements. The explanation of this can be found at the US DOS Site.

    There is no published listing of all the relationships of Hague accredited agencies and supervised providers, making due diligence the burden of the prospective adoptive parent. Proceed with caution when considering a placing agency that is working under the supervision of an accredited provider.

  5. If adopting internationally, contact the US Embassy in the country you are considering (contact information) to see if any complaints have been lodged against the agency.

  6. Join the Adoption Agency Research (AAR) group for international adoptions and Adoption Agency Research Domestic (AARD) group for US domestic adoptions and ask questions.

  7. Join email lists, chat boards and country specific Yahoo groups. Talk to families who have recently completed adoptions with the agency, from the country you are considering there. You can find a list at Karen's Adoption Links and PEAR's Blog post Crises in Adoption: Resources.

  8. Join local adoption support groups. Talk to families who have recently completed adoptions with the agency, from the country or state you are considering. Some local adoption groups can be found in state directories support sections on this page or local country-specific groups can be found at PEAR's Blog post Crises in Adoption: Resources.

  9. Check adoption ethics related websites for information on agencies and practices that may raise ethical or legal concerns: 

    Schuster Institute
    Adoption Agency Checklist
    Pound Pup Legacy

  10. Check the archives on PEAR's blog for agency specific or country specific information.

* Special note about interpreting BBB complaints or lack of BBB complaints. BBB terms of memberships and procedures for complaints vary by region but the BBB will often attempt to mediate a case with both parties. How successful this is varies by the program with some being very aggressive about complaints and having vigorous professional mediation (community dispute resolution) programs and others just having someone review submitted statements on the phone with each party and making an attempt to get the matter informally settled. BBB members must agree to arbitrate their unresolved grievances if demanded by the customer. It is usually binding arbitration. This can give the adoptive parent/prospective adoptive parent recourse against the agency without going to court. If the agency declines, then they get a black mark and cannot claim they are member in good standing. However, once the agency agrees to arbitration, the adoptive parent/prospective adoptive parent forfeits their right to litigate. Contact your attorney for advice before agreeing to any contract or arrangement which forfeits their right to seek redress in the courts. Furthermore, the BBB has no ability to enforce the arbitration or a decision against a member. The arbitrator may be bound to strictly interpret the contract even if the contract is unconscionable, overreaching and biased against the adoptive parent/prospective adoptive parent. If the contract says the agency isn't liable for their subcontractors, unforeseen foreign circumstances, failure of foreign government or the myriad other exculpatory excuses that agencies put into their contracts, then the action by the complainant adoptive parents/prospective adoptive parents may fail. The arbitrator can examine any evidence presented by either party and decide how credible it is. The arbitrator has latitude to accept or reject evidence and does not have to comply with the formal rules of evidence.

In this respect, an adoptive parent/prospective adoptive parent may do better in the courts, even small claims, where a judge has the authority to decide the contract is unreasonable (an "adhesion" contract) and unfair and award damages to the complainant despite a contract basically saying the agency can never be held liable for anything ( as we see so often).

There is no downside to making an initial complaint but for many programs nothing will happen unless the adoptive parents/prospective adoptive parents are aggressive and push the BBB and follow up and demand they do something about the complaint. Many BBBs are understaffed and work is done by a lot of volunteers.

** Special note about interpreting lack of COA complaints: Lack of complaints against an agency is not equivalent to lack of issues or ethical business practice. There is a barrier to prospective adoptive parents filing a complaint in that the agency is immediately informed of who has lodged the complaint; rightly or wrongly, a prospective parent may feel that their ability to complete an adoption is in jeopardy if they come forward.
Print Version PEAR Guide to Researching US Adoption Agencies (pdf)

PEAR Positions on Health Issues in Adoption

                                                                                                                                                                                                                                                                                           

PEAR Observational Survey of Adoptive Parents
on Success, Satisfaction and Types of Post-Adoption Services (POSitive Study)

Results of POSitive Study on Post Adoption Services (pdf)

POSitive Survey Plan of Action:
  • Informing the Adoptive Parent Community: Information will be shared about explanations of interventions and practical tips. Ongoing.
  • Bringing different health care sectors together to solve gaps brought up in survey. Ongoing.
  • Evaluating insurance and legal issues: Ongoing.
Long Term Goal:
  • Recommending a healing roadmap: Interactive flowchart to assist parents in determining timing and types of interventions.
                                                                                                                                                                                                                                                                                           

Therapist and Mental Health Provider Surveys:

  • Therapy Provider Survey (click to start the Therapist survey)

    • Please share details about Licensed Child Therapists (occupational, speech, physical, neurofeedback, craniosacral therapists, etc.) who are knowledgeable about adoption, institutionalization, and/or prenatal substance use issues.

    • Eight quick questions: Practice name, practioner, type of therapy(s), website, physical address, phone/email, insurance accepted, other information.

  • Mental Health Provider, Facility and Camp Survey (click to start the Mental Health Provider survey)

    • Please share details about Licensed child/family Mental Health Providers, Facilities, and Camps who are knowledgable about adoption, institutionalization, and/or prenatal substance use issues.

    • Eight quick questions: Practice, school, or facility name, practioner, type of practioner or facility, website, physical address, phone/email, insurance accepted, other information.

Providers and facilities will be considered for inclusion in our State Directories of Adoption Resources under one of the following categories: Health, Education or Support.


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Parents for Ethical Adoption Reform (PEAR)
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