Name of the Organization : Arizona Department of Health
Type of Facility : Register a Home Birth
State : Arizona
Country : United States of America
Website : http://www.azdhs.gov/licensing/vital-records/index.php#register-birth-home-birth
Acknowledgement : https://www.statusin.org/uploads/24283-acknowledgement.pdf
Register a Home Birth :
** Please contact the Vital Records Office in the county where the birth occurred for further information concerning the requirements and the office procedures for registration.
** The Certificate of Live Birth Worksheet is also available at any of the local county Vital Records Offices.
Related : Arizona Department of Health Apply for Birth Certificate : www.statusin.org/24268.html
** Requirements to Register Births for Home Births within the 7-Day Timeframe
** When a child is born at home, who may complete the Certificate of Live Birth Worksheet and submit it to a Vital Records Office to register the child’s birth?
** A physician, nurse or midwife who attended the birth shall collect and complete all the required information listed on the worksheet to include the parents’ social security numbers, the signature of the attendant and informant, and evidentiary documents.
** If a medical professional did not attend the child’s birth, the child’s mother, father or family member of legal age (18 years of age or older) who was present at the birth shall collect and complete the information on the worksheet (A.R.S. § 36-333).
If the worksheet is received by the Vital Records Office within 7 days of the birth, the following must be submitted :
** Certificate of Live Birth form must be completed and signed by the informant and attendant and must be forwarded to the County or State Vital Records office.
** Contact Vital Records to obtain a Certificate of Live Birth form and instructions packet.
** If the parents are married, a certified marriage certificate must be submitted.
** If the parents are not married, an Acknowledgement of Paternity or Court-Ordered Paternity (certified copy) must be submitted before the father can be added to the birth certificate.
Note :
** Other documents to support registration of the birth certificate may be requested.
** If the worksheet is submitted by mail, the mailing envelope must be postmarked within 7 days of the birth.
Requirements for Late Registration : (More than 7 days but less than 1 year)
** If a child’s birth is being registered more than 7 days but less than 1 year after birth, a parent may register their child’s birth by submitting the following documents, as per A.R.S 36-333.01 and A.A.C. R9-19-202,
** a physician, nurse or midwife who attended the birth shall collect and complete all the required information listed on the worksheet to include the parents’ social security numbers, the signature of the attendant and informant, and evidentiary documents.
** If a medical professional did not attend the child’s birth, the child’s mother, father or family member of legal age (18 years of age or older) who was present at the birth shall collect and complete the information on the worksheet.
** The Certificate of Live Birth Worksheet must be completed and signed by the attendant (person who delivered the child) and the parent/informant (person providing the demographic information on the worksheet.
** Document proving the mother was present in Arizona at the time of birth.
Some examples include but are not limited to :
** Medical record, utility bill, public assistance document, etc.
** The document must show the month and year in which the child was born and also list the mother’s name and address.
** The document must show the date it was established.
** Document proving the child was present in Arizona at the time of birth.
Some examples include but are not limited to :
** Medical record, church record, public assistance document, etc.
** The document must show the child’s date of birth or at a minimum the month and year in which the child was born and mother’s name and address is preferred but not required.
** The document must show the date it was established.
** If the parents are married, a certified copy of the marriage certificate/license.
** If the parent’s are not married, an Acknowledgement of Paternity or Court-Ordered Paternity must be submitted before the father can be added to the birth certificate.
Note: Other documents to support registration of the birth certificate may be requested.