Penn. TC- 15.3 - 15.4
A proposed decree shall be prepared and presented to the Court in substantially the form set forth below:
(CAPTION)
DECREE
AND NOW, this _____ day of _________ , 20___, from the evidence presented at the hearing held on _______ _____ , 20___, on the Petition to (Confirm Consent) or (Terminate Parental Rights), the court finds the averments of the petition are true, that the requirements of the Adoption Act have been met, and that the interest and welfare of the minor child, ___________ will be served if the petition is granted. As a result, the parental rights of ____________ , relative to the child, ____________ are hereby forever terminated and further adoption proceedings concerning the child may go forward without notice to, or consent from, ____________________ .
_____________________ , whose parental rights are terminated hereby (is/are) advised that (he/she/they) continues to have the right, at anytime, to place and update personal and medical history information on file with the Court, and with the Department of Health and Public Welfare, pursuant to the provisions of the Adoption Act. Non-identifying medical history information placed on file may be disclosed to the adoptive parents, or his or her or their physician, or, once the child attains the age of eighteen, to the child's physician. Other personal information placed on the file may be disclosed upon the request of the child who has attained the age of eighteen, or, if the child is less than eighteen, upon the request of the child's adoptive parent or legal guardian.
BY THE COURT:
_____________________________
Robert E. Dalton, Jr., President Judge
Penn. TC- 15.3 - 15.4