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Responding to a Referral

By now, it’s been many months since you submitted your dossier to CARA. Then, the day arrives and your adoption agency reaches out to let you know that you finally have a referral!

What to expect in a referral?

Even though CARA guidelines state that you should get referrals for two children, it’s quite possible that you’ll get only one referral. The CARA referral should include three documents each child:

  1. Child Study Report (CSR) – A report that should have details about the child
  2. Medical Exam Report (MER) – The medical history of the child
  3. Photograph of the child

You’ll have 96 hours to reserve the child, but don’t assume you’ll have the whole time since the clock starts ticking when CARA forwards the referral to your agency. Be sure to check with your agency about the deadline because some time might have already lapsed because of time zone differences, holidays, etc.

What to do once you have a referral?

  1. Carefully go through the CSR and MER for any inconsistencies in birth dates, date of admission into the orphanage, etc.
  2. Contact a pediatrician that specializes in international adoption to assess the information provided about the referred child. Search other adoptive parent forums for referrals. Here is a list compiled by an adoption agency of some pre-adoption assessment clinics.
  3. Make sure your doctor understands the tight deadline you are up against (most of them are used to this and have quick turnaround times) and share all three documents with them.
  4. Be aware that a pre-adoption assessment of medical and photographic records can have limited value in detecting or predicting future issues. But the doctor may help you identify things which may suggest possible medical or developmental problems. The doctor may also ask for additional information and suggest medical exams that might be needed.
  5. Make a decision and confirm one of the referrals before the deadline. Not doing so will put you at the end of the queue and it could take several months before you receive another referral. You will 30 days after this to do additional diligence and formally accept the referral.
  6. If the referrals do not meet your criteria (age, health conditions etc.) specified during the CARA application process and you’re not comfortable moving forward, make sure to communicate this to CARA through your agency and have CARA acknowledge this fact. You should also appeal to CARA in writing that since the child referrals did not meet your requested criteria, you should be referred the next available child and not moved to the end of the queue. Even though your agency is supposed to help you with this process, most agencies are not very aggressive in pushing CARA. In that case, it’s recommended that prospective adoptive parents take the initiative to work directly with CARA.



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