The process of birth registration involves not only the joy of welcoming a new life but also vital administrative steps that officially recognize this new member of society. Among these steps, the completion of the DOH-2184E form, issued by the New York State Department of Health, stands as an essential task. This form serves as the initial documentation for a child's birth certificate and introduces the baby to the Statewide Perinatal Data System (SPDS). Completing this form accurately is crucial as the birth certificate is a foundational document, verifying the child's identity, and it will be used throughout their life for education, employment, obtaining government IDs, and more. Parents are responsible for filling out specific sections of the booklet, ensuring the information is precise for the sake of official records and the benefit of public health initiatives. The form not only collects data necessary for the birth certificate but also gathers information for Quality Improvement (QI), the Immunization Registry (IMM), and the Newborn Screening Program (NBS). These segments facilitate improvements in public health services, immunization tracking, and early intervention for at-risk infants. Furthermore, the booklet outlines a framework for parents to apply for a Social Security number for their child, sealing the vital connection between birth registration and the child’s legal and social identity within the United States. Thus, the DOH-2184E form embodies more than bureaucratic requirement; it is a bridge between the personal joy of birth and the collective responsibility of societal integration.
| Question | Answer |
|---|---|
| Form Name | Doh 2184E Form |
| Form Length | 14 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 3 min 30 sec |
| Other names | 1doh 2184e, new york state birth certificate and statewide perinatal data system work booklet spanish, doh 2556i, birth certificate booklet |
NEW YORK STATE DEPARTMENT OF HEALTH Vital Records – Birth Registration Unit
Birth Certificate and SPDS Work Booklet
Mother’s Name:
Mother’s Med. Rec. Number:
New York State Birth Certificate and Statewide Perinatal Data System Work Booklet
A child’s birth certificate is a very important document. It is the official record of the child’s full name, date of birth and place of birth. Throughout the child’s lifetime, it provides proof of identity and age. As a child grows from childhood to adulthood, information in the birth certificate will be needed for many important events such as: entrance to school, obtaining a work permit, driver’s license or marriage license, entrance in the Armed Forces, employment, collection of Social Security and retirement benefits, and for a passport to travel in foreign lands.
Because the birth certificate is such an important document, great care must be taken to make certain that it is correct in every detail. By completing this work booklet carefully, you can help assure the accuracy of the child’s birth certificate.
New York State Birth Certificate:
PARENTS, for the birth certificate, you must complete the unshaded portions of this work booklet, see pages 3 - 5, 10 - 12 & 14 (the shaded portions will be completed by hospital staff).
Information that is not labeled “QI”, “IMM” or “NBS” in the work booklet will be used to prepare the official birth certificate. The completed birth certificate is filed with the Local Registrar of Vital Statistics of the municipality where the child was born within five (5) business days after the birth and with the New York State Department of Health. When the filing process is completed, the mother will receive a Certified Copy of the birth certificate. This is an official form that may be used as proof of age, parentage, and identity. Receiving it confirms that the child’s birth certificate is officially registered in the State of New York. Additional copies of the birth certificate may be obtained from the Local Registrar or the New York State Department of Health, P.O. Box 2602, Albany, New York
All information (including personal/identifying information) is shared with the County Health Departments or other Local Health Units where the child was born and where the mother resides, if different. County Health Departments and Local Health Units may use this data for Public Health Programs. The Social Security Administration receives a minimal set of data ONLY when the parents have indicated, in this work booklet, that they wish to participate in the Social Security Administration’s Enumeration at Birth program.
While individual information is important, public health workers will use medical and demographic data in their efforts to identify, monitor, and reduce maternal and newborn risk factors. This information also provides physicians and medical scientists with the basis to develop new maternal and childcare programs for New York State residents.
Statewide Perinatal Data System (SPDS) – Quality Improvement (QI), Immunization Registry (IMM) and Newborn Screening Program (NBS) Information:
The information labeled “QI” collected in this work booklet will be used by medical providers and scientists to perform data analyses aimed at improving services provided to pregnant women and their babies. Information labeled “IMM” will be used by New York State’s Immunization Information System (NYSIIS). A birthing hospital’s obligation to report immunizations for newborns can be met by recording all the information in SPDS. This includes the manufacturer and lot number as required by law. Information labeled “NBS” will result in significant improvements in the Newborn Screening Program such as better identification and earlier treatment of infants at risk for a variety of disorders.
ATTENTION HOSPITAL STAFF:
This work booklet has been designed to obtain information relating to the pregnancy and birth during the
New York State Public Health Law provides the basis for the collection of the birth certificate data. For pertinent information about the New York State Public Health Laws refer to sections 206(1)(e), 4102, 4130.5, 4132 and 4135. These laws are also described in the New York State Birth Certificate Guidelines. The Guidelines are available to SPDS users on the Help tab of the SPDS Core Module.
New York State Birth Certificate and Statewide Perinatal Data System Work Booklet |
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NEW YORK STATE DEPARTMENT OF HEALTH Vital Records – Birth Registration Unit
Birth Certificate and SPDS Work Booklet
New York State Birth Certificate and Statewide Perinatal Data System Work Booklet |
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NEW YORK STATE DEPARTMENT OF HEALTH Vital Records – Birth Registration Unit
Birth Certificate and SPDS Work Booklet
Help for Parents Completing This Work Booklet
Page 4: Last Name on Mother’s Birth Certificate
This is commonly referred to as “maiden name.” If the mother was adopted, it would be the last name on her birth certificate after the adoption.
Page 4: Infant’s Pediatrician/Family Practitioner
Enter the name of the doctor who will care for the infant after he/she is released from the hospital. This may or may not be the same as the doctor who cared for the infant while in the hospital.
Page 11: Last Name on Father’s / Second Parent’s Birth Certificate
Father: This is usually the same as his current last name. In the event that a man has changed his last name through marriage, the name on his birth certificate should be entered here. This may or may not be the same as his current last name depending on whether his name was changed by marriage only or changed through a court proceeding which resulted in an amendment to his birth certificate.
Mother (Second Parent): This is commonly referred to as maiden name and is the name on her birth certificate.
In either case: If the parent was adopted it would be the last name on his or her birth certificate after the adoption.
New York State Birth Certificate and Statewide Perinatal Data System Work Booklet |
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