1. Name, date and place of birth and address.
2. Marital status and date and place of marriage (if any).
3. Nationality and race.
4. Past and present relationship (if any) with other birth parent including an assessment of its stability.
5. Names, addresses and brief details of the personal circumstances of parents of the birth parents and any of the birth parents' brothers and sisters, with their ages or ages at death.
6. Physical description.
7. Personality.
8. Religion, including any wishes in respect of the child’s religious upbringing which each parent has in respect of the child’s adoption.
9. Educational attainments.
10. Past and present occupation.
11. Whether the mother, if she has parental responsibilities, agrees to the child being adopted and, if not, her reasons for not agreeing.
12. Whether the father, if he has parental responsibilities, agrees to the child being adopted and, if not, his reasons for not agreeing.
13. If the father or mother does not have parental responsibilities in relation to the child whether he or she is intending to apply for, a parental responsibilities order or enter into a parental responsibilities agreement.
14. Whether there is any history of genetically transmissible or other significant disease in the family history of either the father’s or mother’s family.
15. A comprehensive medical report signed by a fully registered medical practitioner, including such details as the medical adviser to the adoption agency considers necessary in regard to each parent.
16. Any other relevant information which the adoption agency considers may assist the panel.