Adoption Records Search Program Evaluation

Use of form: Use of this form is voluntary. Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1)(m), Wisconsin Statutes].

Instructions: Complete this form to provide feedback on your experience utilizing the Wisconsin Adoption Records Search Program. Evaluations will remain anonymous unless follow-up is requested under Section IV of this form.


How did you first learn about the Adoption Records Search Program (ARSP)?
What was your motivation to request a record search or outreach request at this time? Select all that apply.
Did you receive identifying information as a result of your record search or outreach request?
Have you already or do you plan to attempt to make contact based on information you received?

Evaluate the program’s services on a scale of 1-5, with 1 indicating a low level of satisfaction and 5 indicating a high level of satisfaction:

Did our office staff respond efficiently and effectively to your questions and concerns?
Did the application materials provide clear direction on completion of the forms?
Were you satisfied with your search specialist’s level of knowledge and skills in completing your search?
Were you satisfied with the level of commitment, care, and concern your search specialist gave to your request?
Were you satisfied with the amount of time required to complete your request?

Section II. Program Recommendations

Section III. Demographics

Demographic information is collected for data analysis purposes only; results will remain anonymous, and no attempt will be made to identify respondents based on their demographic information.

I am a(n):
Race/Ethnicity (select all that apply):

Section IV. Request for Contact

ONLY COMPLETE THIS SECTION IF YOU WOULD LIKE TO BE CONTACTED FOR EITHER OF THE REASONS LISTED BELOW. If you check one or both boxes in this section, provide your preferred contact information and then sign and date this evaluation form.

If you would like to be contacted but would still like your evaluation to remain anonymous, leave Section IV blank and contact the ARSP at or (608) 422-6928 to request follow-up.

Sign above

DCF-F-5620-E (R. 05/2023)