The Department of Health and Hospitals Office of Public Health Vital Records Registry has developed a crucial document for families experiencing the profound loss of a stillbirth, known as the Phs520D form. This application enables them to officially request a Birth Resulting in Stillbirth Certificate, providing documented recognition of their child’s birth. Revised in September 2007, the form outlines a straightforward process for submission, which includes completing the application, including a state-issued photo ID, and enclosing the appropriate fees via check or money order to the Vital Records Registry in New Orleans, Louisiana. Importantly, the form clarifies that no fees are required for the initial certificate, while additional copies are available for a nominal fee. It also details the necessary precautions against fraudulent applications, with stern penalties for those who falsify information. The Phs520D form serves not just as a procedural document but as a compassionate acknowledgment of a birth and a loss, underlining the state’s commitment to recognize all births, regardless of the outcome. The application process is designed to be respectful and accessible, acknowledging the sensitive nature of the request and the importance of offering a tangible form of recognition to grieving families.
| Question | Answer |
|---|---|
| Form Name | Form Phs520D |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | BirthResultingS tillbirthApplic ation louisiana phs520f form |