Simplifying Child Adoption: CARA Adoption Detailed Process and Medical Fitness Certificate Requirements Explained

11 March, 2025 Bangalore- India has witnessed a notable increase in child adoption trends over the past decade. According to the Central Adoption Resource Authority (CARA) annual report there were a total of 4029 – 3,580 in-country and 449 inter-country adoptions, and children were adopted in the year 2023-2024. While the interest in child adoption increased in the past decade, the legal maze, complicated documentation, and procedural hassle continue to pose challenges for prospective parents and children awaiting to be adopted.

Out of the complexities involved in the child adoption process in India, one of the biggest roadblocks is the lack of awareness surrounding the medical fitness certification for prospective parents. While it is a mandatory requirement, the unclear guidelines, confusing paperwork, and the fact that even medical professionals are unaware of the exact process, often delay the journey of becoming a parent.

In such a scenario, having assistance in at least attaining genuine medical fitness certification can make child adoption easier for parents. MedicalCertificate.in has helped hundreds of prospective parents move forward with confidence by providing clear instructions, guiding them through required medical documents, and offering certificates in the correct formats for different CARA agencies. 

“We uphold stringent compliance and quality standards, driving efficiency and accessibility in healthcare. Our dedication fosters the integration of digital health solutions, enabling transparent healthcare delivery in alignment with the Ayushman Bharat Digital Mission (ABDM) compliance,” says Parul Pandey, COO of MedicalCertificate.in, adding “Each document undergoes thorough verification to ensure authenticity, giving adoptive parents peace of mind as they navigate the adoption process.

Beyond just issuing medical certificates, Pandey added, “MedicalCertificate.in guides adoptive parents through the correct process based on their state, city, or CARA agency requirements. Our trained professionals help parents understand what is actually needed at each stage, our doctors assist in understanding necessary reports, preventing unnecessary tests or confusion making the process smoother and less overwhelming. By providing accurate guidance and step-by-step assistance, we ensure that parents save time, money, and effort while fulfilling only the necessary medical requirements.”

The Role of Central Adoption Resource Authority: Your Adoption Ally!

The Central Adoption Resource Authority (CARA) serves as a statutory body under the Ministry of Women and Child Development, Government of India, to look after and monitor both domestic and international adoption procedures.

The National Authority of India under the Hague Convention on Inter-country Adoption (1993) provides for the smooth, ethical, and open performance of every adoption procedure. The organization enables authorized agencies to place orphaned, surrendered, or abandoned children for adoption. A total number of approximately 18,000 adoptions were done over the past five years including both in-country and inter-country according to the official data from CARA. Highlighting a steady commitment to finding children a home with loving parents.

Detailed Child Adoption Process in India:  Steps to a Happy Adoption

1. Registration with CARA

Registration with CARA Prospective adoptive parents start their adoption journey by signing up on the CARA online portal.

Documents Needed:

• Identity Proofs: Options include an Aadhar card, passport, or voter ID.
• Income Certificates: This can be in the form of salary slips, bank statements, or income tax returns.
• Medical Certificates: These must meet CARA standards and confirm the health status of the adoptive parents.

The process of sign-up takes a few days and the registration stays valid until you complete the home study. If the parents make mistakes or leave out information when they sign up, they might need to sign up again. 

2. Home Study Report

After you sign up, CARA assigns a professional social worker to assess your home. 

The social worker looks at the adoptive parents’ home environment. They check financial stability and see if they are ready to be parents through adoption. 

Normally this stage takes between 1 to 3 months and the validity of this study report is up for 6 months. If the social worker doesn’t approve home study, then the parents will need to fix the issues they point out and go through a new assessment.

3. Matching the Child with Parents

After home study approval, CARA pairs potential parents with kids based on their choices. Parents get two full days to choose whether they want to accept the match. The pairing process can take from several months up to a year. If parents say no to three referrals, CARA might cancel their registration. They can apply again after they address any issues, but they might need to wait for a new sign-up period. 

4. Pre-Adoption Foster Care

Once parents accept a match, they go to the child care center to build a bond with the kid. This phase can last anywhere from a few days to many months depending on how old the child is and how ready they are. For young kids (under 2 years old), the process might involve quick visits to help them get used to their new surroundings.

5. Court Approval for Adoption

Right after the foster care time wraps up, the concerned adoption agency running the adoption place put through a court application. 

Both the child and the adoptive parents are required to appear in the judicial hearings. The process takes anything from 6 months to one year. The child will go to court, but the hearings are normally in private. The court will consider the case prior to issuing the final adoption order. If the child is too young, the court may hear the case without them, using reports and documentation to approve adoption.

6. Issuance of Birth Certificate

Once the court grants approval for the adoption, the agency helps to procure a new birth certificate for the child, with the adoptive parents’ names as legal guardians. The new birth certificate will contain the name of the child, date of birth, and place of birth. In case the original birth certificate is missing, the agency will work with the court to determine the required information.

7. Post-Adoption Follow-Up

Once the adoption is complete, the child will be followed up by adoption agencies for two years to facilitate an easy adaptation. Once two years of follow-up are complete, parents can take the child abroad from India if moving out. The follow-up process will be based on the policies of the host country.

If the child is taken abroad, they should ensure legal documents, citizenship, and continued surveillance to guarantee the well-being of the child.

The whole adoption process may last anywhere from 6 months to 2 years, depending on numerous factors including the availability of children, responsiveness of agencies, and fulfillment of legal requirements.

Eligibility Criteria: Are You Prepared to Adopt?

Age Requirements:

You are required to be 25 years and above for you to adopt a child. There should be a 25-year gap in age between you and the child you are interested in adopting.

If you are single, these are the age limits for adopting according to the age of the child:

• For a child who is up to 2 years old, you can be 40 years old.
• For a 2 to 4-year-old child, you can be a maximum of 45 years old.
• For a 4 to 8-year-old child, you can be a maximum of 50 years old.
• For an 8 to 18-year-old child, you can be a maximum of 55 years old.

If you are a couple, your ages should combine within these limits:

• For a child aged 2 years and below, your combined age can be as much as 85 years.
• For a child aged 2 to 4 years, it can be as much as 90 years.
• For a child aged 4 to 8 years, it can be as much as 100 years.
• For a child aged 8 to 18 years, it can be as much as 110 years.
• The upper limit of the age of a child you can adopt is 18 years.
• When adopting a step-child or a relative, age restrictions do not apply.

Gender Requirements:

• Married couples can adopt a child of any gender, no matter how many children they already have.
• If you’re a single female, you can adopt a child of any gender.
• If you’re a single male, you can only adopt a male child.

Marital Status:

• Anyone, whether married or single, can adopt a child.
• However, if you’re a couple, you need to have been married for at least two years before you can adopt.

Other Conditions:

• You need to be physically, mentally, and emotionally stable which is determined by the medical fitness certificate issued by a government registered doctor.
• You should be financially capable of supporting a child.
• If you already have two or more biological children, you generally can’t adopt, unless you’re adopting a special needs child, a child in immediate placement, a relative, or a step-child.

Rights of the Adopted Child

Indian adopted children have some important rights to ensure their health and well-being and smooth integration into new families:

1. Right to Identity: They are entitled to know about their identity and their background, along with information on biological parents if any.
2. Right to Love and Care: The adopted child should receive love, care, and nurturing from his/her adoptive family as the biological children receive.
3. Right to Education: Adopted children are also entitled to a good education, which provides them equal opportunities compared to their peers.
4. Right to Protection: They deserve protection from abuse, neglect, or discrimination.
5. Right to Participate: They can give their opinions and take part in decisions that impact their lives, making them feel like part of the family.

By promoting these rights, CARA, and adoptive families provide a home environment where every child can flourish.

Legal Adoption & Child Rights in India

Through legal adoption, a child gains all rights, privileges, and responsibilities that belong to biological children. CARA established its framework for adoption in 2006, by following essential guidelines:

1. The best interests of the child become the deciding factor throughout each phase of the adoption process.
2. Indian citizens from the child’s social and cultural surroundings get first priority for adoption.
3. All adoptions require entry into the Child Adoption Resource Information and Guidance System (CARINGS) making them transparent.

International Adoption: Eligibility & Preferences in India

UNICEF’s State of the World’s Children Report identified that 29.6 million (2.96 crore) children were orphaned in India in 2014. But according to CARA, fewer than 500,000 reach institutionalised care and only 3000 to 4,000 are adopted annually.

International adoption in India has seen a decline in numbers post-pandemic, with 3,559 children placed for adoption in 2020-21. Eligibility criteria remain stringent, favoring Indian parents, while preferences include age, gender, and health status of children. 

Intercountry adoption is facilitated by the Ministry of Women and Child Development of India under CARA (Central Adoption Resource Authority), which is a nodal agency that operates under the Hague Convention on Intercountry Adoption (1993) to ensure adoption is performed in a fair and legal manner. NRI(Non-Resident Indian), OCI (Overseas Citizen of India), and foreign applicants are eligible, while single women can adopt any child and single men can adopt boys only. Married couples must have a minimum marital life of two years before becoming eligible for adoption.

• What Are the Eligibility Criteria? One needs very good physical, mental, and emotional health. MedicalCertificate.in provides international CARA-compliant medical certificates in just 42 hours.  One must be financially in good standing and compatible in marriage. Married couples have an age limit (allocated by) not passing more than 90 years-subject to the combined age. For singles, one must fall in the range of 45 years to 55 years as per the child’s age. A Home Study Report from an accredited body in the respective country must be prepared.
• Who Gets Priority in the Adoption Process? NRIs and OCI will have a preference for the adoption of Indian children over foreign applicants. Foreign parents will be considered only on condition that no Indian or NRI/OCI applicants select a child within that timeframe.
• How Does the Adoption Process Work? The procedure begins with registration by one of the Authorized Foreign Adoption Agencies, conducting the Home Study Report. CARA does a matching of the parents with child profiles, which is followed by legal verification of adoption. The adoption gets approved by the Indian courts through a Court Process, and it is here that the child’s Indian passport is issued with an adoption decree for the visa to the new country. Besides, the parents will also have to do CARA post-adoption reports.

The Adoption Approval Stamp: Why the Medical Certificate Matters!

Outlining that the adoptive parents are mentally, emotionally, and physically fit to take care of a child is one of the most important parameters of a child adoption process as it outlines the healthy and stable life of the adoptive child. While submitting a medical fitness certificate a CARA-compliant medical certificate is mandatory as it verifies that the adoptive parents are legally not suffering from incurable, contagious, or life-threatening diseases and are mentally and emotionally healthy to take care of a child.

Here’s a basis of why a medical fitness certificate for adoption is essential:

• The medical certificate verifies that the adoptive parents do not have critical health problems that would affect childcare because of medical conditions.
• The evaluation process determines emotional strength and searches for serious psychiatric conditions affecting parenting ability.
• Confirms no past or present issues with alcoholism, drug dependency, or other addictions.
• The assessment judges an adoptive parent’s future health perspective to provide enduring care to their child.

A suitable home environment serves as a protective safety measure for promoting child development properly.

The Adoption Regulations of 2022 issued by CARA under the Juvenile Justice (Care and Protection of Children) Act, 2015 lays down the medical certificate requirement. The medical certificate needs to be generated from a registered medical practitioner. 

CARA specifies a particular format for medical certificates used in adoption which legalizes adoption requirements and promotes authenticity and standardized assessments. 

MedicalCertificate.in aims to replicate the compassionate simplicity of adoption when it comes to medical certification procedures.

CARA Medical Certificate Format for Adoption in India

The prescribed format for this certificate exists as per guidelines set by the Central Adoption Resource Authority (CARA) to ensure legal validity together with standardization and transparency are:

• The certification requires doctor’s information including their full name with NMC or State Medical Council registration number. It should also have their details and official contact information.
• Complete and detailed personal information which includes names together with age and sex and residential address and contact information.
• Medical Examination for physical fitness, chronic conditions (diabetes, hypertension, heart disease), mental and emotional health, substance abuse history, and overall health/life expectancy.
• Doctor’s Certification stands as a medical declaration that verifies the adoptive parent(s) has the fitness needed for adoption.
• A doctor must include their signature together with their registration details on the medical fitness certificate.

A medical certificate can be issued either on the doctor’s letterhead or the letterhead of a hospital or clinic. In either of the conditions doctor’s clear details like their name, education, registration details, and signature are the prime importance. They also need to ensure that a proper detailed understanding of the medical examination is mentioned in the medical fitness certificate complying with CARA’s standards. There are multiple CARA approved formats that are used by different adoption agencies and thus it is always recommended to cross-check the medical fitness certificate format with the adoption agency for conformity to their particular protocols and to take the certificate from a genuine platform only.

Types of CARA Medical Certificates:

• Basic Medical Certificate – Confirms the physical, mental, and emotional fitness for the initial registration and home study.
• Comprehensive Health Assessment Certificate – Contains a detailed health history, mental health assessment, and substance abuse screening for court or inter-country adoption.
• Updated Medical Certificate – Required if the validity of the last one has expired to confirm continued fitness.
• Varied Agency-Specific Formats – Custom certificates designed to meet agency-specific criteria.

MedicalCertificate.in eases the entire adoption process by delivering CARA-compliant medical certificates for all stages of adoption and as per the adoption agency. They ensure medical documents are genuine, and issued with the proper investigation so as to ensure the prospective parents don’t face hassle in the future. The company adheres to government compliances and issues medical certificates with doctor consultation in all formats including digital medical fitness certificates, handwritten medical fitness certificates, and custom medical fitness certificates, and also ships the handwritten document as requested.

What Health Tests Are Required? 

While submission of your mental, physical, and emotional health is mandatory for CARA-approved medical certificates, not every format requires you to undergo multiple medical tests. Before undergoing any kind of medical test, it is recommended you get your medical certificate cross-verified by a medical practitioner to understand the format issued by your assigned agency or while you are submitting what are the necessary details. However, if you are being suggested a specific format for Caring, usually it requires a compilation of the following tests to be conducted:

1. Serology Test
2. Haemoglobin Test
3. Blood Smear Test
4. Urinalysis – Specific Gravity
5. Urinalysis – Sugar
6. Urinalysis – Albumin
7. Other vital signs must be checked as part of adoption screening to confirm adoption fitness.

Understanding Who Can Issue Your Adoption Medical Certificate 

To get a medical certificate for adoption, you should know a couple of key things:

1. Registered Medical Practitioners:

A registered MBBS doctor can give you a medical certificate for adoption. You don’t need a doctor with a special “CARA-approved” status. Any doctor who has registered with the National Medical Commission (NMC) or a State Medical Council can help. This includes doctors from government hospitals, private clinics, or health tech platforms. The key is that the doctor knows about the adoption process and what specific details to put on the certificate.

2. Local Guidelines Matter: 

The process of medical evaluation has to adhere to local rules and regulations, which may differ per location. This implies that various locations might have extra requirements for inclusion in the medical assessment. For instance, certain areas may demand particular tests or health evaluations that others may not.

3. Consult Your Adoption Agency: 

It’s important for prospective adoptive parents to get the right report format and specific health requirements from their Specialized Adoption Agency (SAA). Your SAA will show you what you need based on your local rules making sure you have the complete picture.

4. Purpose of These Regulations: 

These rules have an impact on making the adoption process easier to handle for adoptive parents. Adoptive parents should follow local area rules and team up with adoption agencies, making sure they adhere to all the rules and regulations. 

Documents required for adoption in India:

Both domestic and international adoptions require specific documents and follow a structured legal process. The prospective adoptive parents (PAPS) are required to submit:

1. Identity proof: Aadhar Card/Passport/Voter ID/Driving license/PAN Card.
2. Address proof: Aadhar/Voter ID/Passport/Electricity/Telephone bill.
3. Proof of income: Salary slip/Income certificate/IT returns.
4. Medical certificate that states the PAPs are free from chronic, contagious, and fatal diseases.
5. Marriage/divorce certificate/death certificate of spouse (if applicable).
6. Consent from older children in the family.
7. An undertaking by a relative in the case of single adoptive parents.

Where to Get a Medical Certificate for Adoption in India? 

Prospective adoptive parents have two options to obtain a CARA-compliant medical certificate:

Option 1: Offline – Traditional Hospital or Clinic Certification

1. Register for a government-approved hospital with an MBBS-licensed medical practitioner for a thorough examination.
2. The doctor will conduct physical and mental assessments to identify medical conditions.
3. Adoptive parents fulfilling medical requirements will receive a CARA-compliant certificate from the doctor.
4. Submit the certificate physically or upload it to the CARA portal at the SAA.

Option 2: Online – Digital Medical Certification 

For faster and hassle-free certification, adoptive parents can opt for online medical certificate services like MedicalCertificate.in:

1. Visit the website medicalcertificate.in
2. Fill in your details, medical history, and existing health conditions.
3. Submit a 15-second full-body walking video, with your height and weight and details of your vitals including blood pressure and pulse.
4. A government-registered doctor will access your details.
5. Once approved, the doctor will issue a CARA-compliant digital or handwritten medical certificate as per your preference.

Why MedicalCertificate.in is a Game-Changer for Adoptive Parents?

The journey of adoption is a beautiful adventure filled with hope and anticipation, but it can also feel overwhelming. That is where MedicalCertificate.in comes in – your go-to health companion in easing this process with CARA-approved medical certificates available online. All it takes are a few clicks, and aspiring parents can finalize their paperwork fast and easily, setting the ground for an uncomplicated adoption procedure.

Since its inception in 2021, MedicalCertificate.in has evolved into a holistic health-tech platform committed to fulfilling the remote healthcare requirements for users across the globe. With a focus on increasing accessibility and convenience, the platform aligns with global and national healthcare standards, including the World Health Organization (WHO), Health Insurance Portability and Accountability Act (HIPAA), National Medical Commission (NMC), and Ayushman Bharat Digital Mission (ABDM). The platform provides services such as online blood testing across more than 220 cities in India and online ear and eye tests, online doctor consultation, and therapy sessions across the globe, all aimed at increasing accessibility to healthcare.

Trusted by users worldwide, MedicalCertificate.in boasts a 4.9-star rating on Trustpilot with over 2,200 positive reviews. As a one-stop healthcare platform, it offers secure, reliable, and easy-to-use services. Guided by the motto “Authentic, Secure, and Convenient,” we remain committed to supporting families at every step of their adoption journey with the right information and expert guidance.

For more information, visit www.medicalcertificate.in, email – care@medicalcertificate.in or call on  080-685-07810 and take the first step toward a smoother, stress-free adoption journey.