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JDF 453

Affidavit of Relinquishment Counseling

Colorado · Colorado Judicial Branch · Effective July 1, 2023

This form is an affidavit that a counselor fills out to state that they provided counseling to someone who is asking the court to give up a child. It lists what topics were covered during the counseling session.

Open the official PDFfrom Colorado Judicial Branch

Where this fits in a case

Hearing

Stage: Hearing

This form is used in a family court case when someone is petitioning the court to relinquish a child. The counselor completes it after providing the required counseling sessions.

Prepared by the court or clerk.

Common questions

Who fills out this form?
The form is filled out by the counselor from the County Department of Social Services or Child Placement Agency. Great care must be taken to fill in the blanks and not change anything else on the form.
What does this form prove?
It serves as an affidavit stating that the counselor provided specific types of counseling to the petitioner regarding the decision to relinquish the child.

Revision history

No changes recorded since we started tracking this form on October 10, 2026. The current version took effect July 1, 2023.

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