Vital Statistics Forms

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Birth and Death Certificate Request Forms    Amendment Forms    Adoption Forms    Paternity and Parentage Forms

Abortion Reporting Forms and Postmortem Examination or Autopsy Consent Form (for physicians only)

 

Request Forms
Birth or Death Record Forms PDF

VS 142.21 – Expedited Application for a Certified Copy

Download (29K)

VS 142.3 – Mail Application for a Certified Copy

Download (28K)

VS 142.6 – Mail Application for a Verification Letter

Download (77K)

VS 142.7 Mail Application for a Certified Copy - Military Personnel being Deployed

Download (74K)

VS 144 – Heirloom Gift Certificate

Download (74K)

VS 301 – Application for Certificate of Birth Resulting in Stillbirth

Download (174K)

 

Amendment and Disinterment Forms
Birth or Death Record Amendment Forms PDF
VS 170 – Application for an Amendment to a Birth Record Download (58K)
VS 172 – Application for an Amendment to a Death Record Download (45K)
VS 2318.1A – Application for Amended Birth Certificate based on a Court Ordered Name Change Download (32K)
VS 271 – Application for Disinterment Permit Download (17K)
VS 271.1 – Disinterment Consent Form Download (13K)



Marriage and Divorce Request Forms
Marriage or Divorce Record Forms PDF
VS 142.9 – Application for a Verification Letter Download (27K)
VS 146 – Application for an Heirloom Anniversary Certificate Download (27K)



Adoption Forms
Adoption Forms PDF
VS 143 – Request for Identity of Court of Adoption Download (79K)
Central Adoption Registry Application Instructions Download (12K)
VS 2271 – Central Adoption Registry Application Download (39K)
VS 2271 – Central Adoption Registry Application and Instructions (Spanish) Download (128K)
VS-210 Central Adoption Registry Request for Open Records Download (153K)
VS 145 – Adult Adoptee Application for Non-Certified Copy of Original Birth Certificate Download (25K)
VS 160 – Certificate of Adoption (for attorneys and district clerks) Download (53K)
VS 166.531 – Validation Petition Download (23K)
VS 166.532 – Validation Order Download (7K)



Paternity or Parentage Forms
Paternity or Parentage Forms PDF
VS 134 – Paternity Registry Inquiry Request Download (39K)
VS 134.1 – Acknowledgment of Paternity Inquiry Request Download (32K)
VS 166 – Application for a New Birth Certificate based on Parentage Download (113K)
VS-168 Inquiry On Court Of Continuing Jurisdiction For A Child Download (83K)



Abortion Reporting Forms to be submitted to Vital Statistics Data Management Group
Form Name PDF
Medical Emergency Abortion form Download (25 KB)
Third Trimester Induced Abortion Certification Form Download (26K)
Induced Abortion Report Form Download (48K)
Abortion Complications Reporting Form Download (415K)

Abortion Forms to be completed and placed in patient file
Form Name PDF
Medical Emergency Abortion form Download (25 KB)
Third Trimester Induced Abortion Certification Form Download (26K)
Induced Abortion Report Form Download (48K)
Abortions Complications Reporting Form  Download (415K)

Postmortem Examination or Autopsy Consent Form (for physicians only)
Form Name PDF
Postmortem Examination or Autopsy Consent Form Download (415K)

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Last updated November 13, 2014