Child Protective Services

Voluntary Termination of Parental Rights

Background Information

Due to life's circumstances, there are times when a parent makes a difficult decision to voluntarily terminate his or her rights to a child.

Once birth parents have completed the form, the form must be filed with the court where the parent's rights are being terminated.

  • This form can be found on the forms & publications page under Child Protection Services.
  • If you have a question about this form, please call (605) 773-3227.

NOTE: 25-5A-7.2. Medical and social history form required prior to termination -- Filing -- Copy available to adoptive parent -- Failure to comply does not void termination. Prior to the giving of consent to voluntary termination of parental rights, the parent shall complete a medical and social history form which shall be supplied by the Department of Social Services. When completed such form shall be filed with the court of the state where the medical history portion of the adoption proceedings shall take place. A copy of the completed form shall be made available to the adoptive parent prior to finalization of the adoption and to the adoptee upon reaching the age of eighteen years upon written request and proper proof of identification. No voluntary termination of parental rights heretofore or hereafter entered by any circuit court is void or inoperative due to failure to comply with this section.